Provider Demographics
NPI:1649534165
Name:GLASSFORD, KATHERINE S (MAC, PSYD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:S
Last Name:GLASSFORD
Suffix:
Gender:F
Credentials:MAC, PSYD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:S
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:ONAMIA
Mailing Address - State:MN
Mailing Address - Zip Code:56359-0610
Mailing Address - Country:US
Mailing Address - Phone:320-532-4005
Mailing Address - Fax:
Practice Address - Street 1:407 130TH AVE S
Practice Address - Street 2:
Practice Address - City:ONAMIA
Practice Address - State:MN
Practice Address - Zip Code:56359-3115
Practice Address - Country:US
Practice Address - Phone:320-532-4005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health