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Individual
MITZI K GLASS
Active
Individual
MITZI K GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904004491
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
175778
BCBS
VT
05
—
8949140
—
VA
Enumeration date
08/29/2005
Last updated
07/13/2026
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