Provider Demographics
NPI:1982256616
Name:GLASGOW, MARY OLA
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:OLA
Last Name:GLASGOW
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 1:14252 AMBERLEIGH TER
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-5918
Mailing Address - Country:US
Mailing Address - Phone:301-717-7424
Mailing Address - Fax:
Practice Address - Street 1:3700 N CAPITOL ST NW # B
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-8400
Practice Address - Country:US
Practice Address - Phone:202-541-7675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT445225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist