MEDICARE: MRS. MARY ANN GLASER M.S., CCC-SLP

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	235Z00000X	Speech-Language Pathologist	OH-SP 0008	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588612915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY ANN GLASER M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	5335 FAR HILLS AVENUE
Second Line	:	STE 205
City	:	DAYTON
State	:	OH
Zip	:	45429-2317
Country	:	US
Telephone Number	:	937-886-4312
Fax Number	:	937-907-1713

Provider Business Practice Location Address
First Line	:	5335 FAR HILLS AVENUE
Second Line	:	STE 205
City	:	DAYTON
State	:	OH
Zip	:	45429-2317
Country	:	US
Telephone Number	:	937-886-4312
Fax Number	:	937-907-1713

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	09/26/2024

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Directions to “ MRS. MARY ANN GLASER M.S., CCC-SLP” Practice Location

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