Individual
GARY GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
125 CLAIREMONT AVE STE 500, DECATUR, GA 30030-2560
(919) 490-1952
Mailing address
1377 MILTON PL SE, ATLANTA, GA 30316-2019
(919) 490-1952
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY002645
GA
Other
Enumeration date
11/01/2014
Last updated
08/09/2024
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