Individual
MR. COLE E GLASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
1170 S STATE ST, EPHRATA, PA 17522-2601
(561) 444-3512
(800) 915-6119
Mailing address
1170 S STATE ST, EPHRATA, PA 17522-2601
(561) 444-3512
(800) 915-6119
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SW131259
PA
101YM0800X
Mental Health Counselor
SW127698
PA
Other
Enumeration date
11/01/2019
Last updated
11/01/2019
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