Organization
SOUTHERN VALLEY PSYCHOLOGY CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA GLASS PSY.D..,L.P. (PARTNER)
(507) 385-7725
Entity
Organization
Contact information
Practice address
11 CIVIC CENTER PLZ, STE 201, MANKATO, MN 56001-7710
(507) 385-7725
(507) 385-0576
Mailing address
11 CIVIC CENTER PLZ, STE 201, MANKATO, MN 56001-7710
(507) 385-7725
(507) 385-0576
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1383
UCARE
MN
05
—
241913100
—
MN
01
—
318G1SO
BLUE CROSS
MN
Enumeration date
02/18/2007
Last updated
02/04/2013
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