Individual
DR. EUGENE RICHARD GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
317 NORTH MAIN STREET, CARROLL, IA 51401
(712) 792-5931
Mailing address
PO BOX 471, CARROLL, IA 51401
(712) 792-5931
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
642
IA
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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