Individual
EMILY LAUREN GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
3711 USF CITRUS DRIVE, TAMPA, FL 33612
(813) 974-9844
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA13927
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110702400
—
FL
01
—
Y911W
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/27/2021
Last updated
07/19/2021
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