Individual
ANGIE GLOSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12800 E WARREN AVE, DETROIT, MI 48215-2061
(313) 824-8000
(313) 824-5589
Mailing address
8200 E JEFFERSON AVE APT 1402, DETROIT, MI 48214-3972
(313) 204-4610
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
4704141314
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10040712800
HAP
MI
Enumeration date
01/29/2014
Last updated
01/29/2014
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