Healthcare Provider Details

I. General information

NPI: 1164357562
Provider Name (Legal Business Name): AUTUMN ROCHELLE GLASPIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12890 QUINTA WAY
DESERT HOT SPRINGS CA
92240-4852
US

IV. Provider business mailing address

PO BOX 580022
NORTH PALM SPRINGS CA
92258-0022
US

V. Phone/Fax

Practice location:
  • Phone: 760-660-0396
  • Fax:
Mailing address:
  • Phone: 760-660-0396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: