Individual
DR. KENNETH WILLIAM GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
309 W SCHOOL HOUSE LN, PHILADELPHIA, PA 19144-3846
(267) 357-7294
Mailing address
309 W SCHOOL HOUSE LN, PHILADELPHIA, PA 19144-3846
(267) 357-7294
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS008735L
PA
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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