Provider Demographics
NPI:1770388647
Name:GLASER, EMILIA
Entity type:Individual
Prefix:
First Name:EMILIA
Middle Name:
Last Name:GLASER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 WISBOROUGH CT
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-0020
Mailing Address - Country:US
Mailing Address - Phone:919-448-1604
Mailing Address - Fax:
Practice Address - Street 1:13415 CAMERON GROVE LOOP APT 205
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-2840
Practice Address - Country:US
Practice Address - Phone:919-448-1604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-15
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20972101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health