MEDICARE: SONJA GLASCO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	38703	TX

General Provider Information

NPI Number	:	1497471700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONJA GLASCO

Provider Business Mailing Address
First Line	:	110 W OTIS AVE
Second Line	:
City	:	SALINA
State	:	KS
Zip	:	67401-8713
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 CHICAGO AVE
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79416-1605
Country	:	US
Telephone Number	:	785-825-0541
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2022
Last Update Date	:	03/21/2023

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Directions to “ SONJA GLASCO ” Practice Location

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