person
Thomas George Glaza, MA,MED
Professional Counselor in North Port, Florida
NPI 1548247968

Thomas George Glaza is a Professional Counselor based in North Port, FL and is specialized in Professional. Thomas George Glaza practices in North Port, FL and has the professional credentials of MA,MED. The NPI Number for Thomas George Glaza is 1548247968 and holds a License No. 2188 (Florida).

The current practice location address for Thomas George Glaza is 12497 Tamiami Trl S, North Port, FL and can be reached out via phone at 941-429-0804 and via fax at 941-429-0814.

Location: 12497 Tamiami Trl S, North Port, FL, 34288-8266
person
Provider Profile Details
NPI Number
1548247968
Provider Name
Thomas George Glaza
Credential
MA,MED
Provider Entity Type
Individual
Gender
Male
Address
12497 Tamiami Trl S, North Port, FL, 34288-8266
Phone Number
941-429-0804
Fax Number
941-429-0814
Provider Enumeration Date
12/28/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2188 01 FL CAP CERTIFICATE
MH5146 01 FL STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
12497 Tamiami Trl S
City
State
Zip
34287-1447
Phone Number
941-429-0804
Fax Number
941-429-0814
person
Provider Business Mailing Address Details
Address
12497 Tamiami Trl S
City
State
Zip
34287-1447
Phone Number
941-429-0804
Fax Number
941-429-0814
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
MH5146 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
2188 (Florida)
Definition
Definition to come...
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