Individual
MRS. SHILLEAH IDORA GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 DUDLEY ST, BOSTON, MA 02119-2769
(617) 438-3226
Mailing address
520 DUDLEY ST, ROXBURY, MA 02119-2769
(857) 249-3112
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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