Glass, Mitzi K
Glass, Mitzi K is an individual health care provider with primary practice located at 1215 Volvo Pkwy Ste 202, Chesapeake VA 23320-7656. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Glass, Mitzi K can be contacted via phone (757) 312-8550.Contact Information
Primary practice address
1215 Volvo Pkwy Ste 202
Chesapeake VA 23320-7656
Phone: (757) 312-8550
Fax: (757) 312-8553
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 0904004491 | Virginia |
Profile Details
| NPI number | 1184617755 |
|---|---|
| LBN Legal business name | Glass, Mitzi K |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 29th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184617755 | NPPES |
| Virginia | MEDICAID | 8949140 | |
| Virginia | Other | 175778 |
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