Individual
BETTY JEAN GLOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
408 W STATE ST, ITHACA, NY 14850-5220
(607) 229-7660
Mailing address
408 W STATE ST, ITHACA, NY 14850-5220
(607) 229-7660
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
076029
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01079267
—
NY
Enumeration date
11/28/2006
Last updated
04/29/2020
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