Healthcare Provider Details

I. General information

NPI: 1902018401
Provider Name (Legal Business Name): EMMY LOU GLASSMAN MA, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10470 ARMSTRONG STREET
FAIRFAX VA
22030
US

IV. Provider business mailing address

8865 APPLECROSS LANE
SPRINGFIELD VA
22153-1250
US

V. Phone/Fax

Practice location:
  • Phone: 703-385-7575
  • Fax: 703-385-7578
Mailing address:
  • Phone: 703-451-7987
  • Fax: 703-569-3215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: