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Individual

MR. HENRY M. GLAZE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
JD, LMFT

Contact information

Practice address
643 N STATE ST, JACKSON, MS 39202-3304
(601) 948-4475
Mailing address
PO BOX 2168, JACKSON, MS 39225-2168
(601) 948-4475

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0143
MS

Other

Enumeration date
05/21/2007
Last updated
07/08/2007
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