Provider Demographics
NPI:1295227403
Name:GLASSER, DIANA NICOLAE
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:NICOLAE
Last Name:GLASSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 GALLATIN PIKE N
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2866
Mailing Address - Country:US
Mailing Address - Phone:156-460-4366
Mailing Address - Fax:
Practice Address - Street 1:620 GALLATIN PIKE N
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2866
Practice Address - Country:US
Practice Address - Phone:615-460-4366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health