Individual
MACKENZIE GLASSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
13498
KS
104100000X
Social Worker
Primary
2024006008
MO
Other
Enumeration date
03/29/2024
Last updated
03/29/2024
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