Provider Demographics
NPI:1952095341
Name:COLON, GLAMARIS (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:GLAMARIS
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19211 INLET COVE CT
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-9729
Mailing Address - Country:US
Mailing Address - Phone:201-370-7856
Mailing Address - Fax:
Practice Address - Street 1:19211 INLET COVE CT
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-9729
Practice Address - Country:US
Practice Address - Phone:201-370-7856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14865235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty