Individual
JASON R GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1312 E LARK ST, SPRINGFIELD, MO 65804
(417) 820-7954
Mailing address
1312 E LARK ST, SPRINGFIELD, MO 65804-7351
(417) 820-7954
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2012010077
MO
Other
Enumeration date
08/05/2010
Last updated
04/24/2019
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