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Individual

BRANDIE DENISE GLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
204 HAMPTON DR, VENICE, CA 90291-8633
(323) 244-5087
Mailing address
204 HAMPTON DR, VENICE, CA 90291-8633
(323) 244-5087

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
106H00000X
Marriage & Family Therapist
139219
CA
106H00000X
Marriage & Family Therapist

Other

Enumeration date
12/22/2020
Last updated
06/21/2023
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