Individual
MRS. CARLY NICOLE GLAESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CF- SLP
Contact information
Practice address
2201 E CENTRAL AVE, BENTONVILLE, AR 72712-5605
(479) 936-1061
Mailing address
2201 E CENTRAL AVE STE 9, BENTONVILLE, AR 72712-5607
(479) 936-1061
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
200524
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200524
ABESPA
AR
Enumeration date
05/21/2019
Last updated
05/21/2019
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