Individual
MRS. JENNIFER LAURIE GLAZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3459 ACWORTH DUE WEST RD NW STE 101, ACWORTH, GA 30101-5820
(404) 919-2951
Mailing address
4817 WILKIE WAY NW, ACWORTH, GA 30102-7928
(770) 584-9446
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004846
GA
Other
Enumeration date
03/15/2012
Last updated
01/03/2020
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