Individual
GINA DIANE GLASSFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
206 5TH ST, HAMPTON, IL 61256-9662
(309) 755-0693
Mailing address
5408 11TH AVENUE A, MOLINE, IL 61265-2863
(309) 781-3158
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146009099
IL
Other
Enumeration date
09/22/2017
Last updated
03/17/2018
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