Individual
MR. JACOB MICHAEL GLOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
723 E 18TH ST, KANSAS CITY, MO 64108-1511
(636) 232-4945
Mailing address
723 E 18TH ST, KANSAS CITY, MO 64108-1511
(636) 232-4945
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
20150117463
MO
101YP2500X
Professional Counselor
Primary
2015017463
MO
Other
Enumeration date
06/16/2015
Last updated
03/09/2026
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