Individual
STACY JO GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11230 STATE ROUTE 364, SAINT MARYS, OH 45885-9534
(419) 394-6757
Mailing address
16625 STATE ROUTE 116, SAINT MARYS, OH 45885-9437
(419) 733-1838
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
005818
OH
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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