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General NPI Number Information
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NPI Number | 1982798401
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Entity Type | Individual
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Provider Name | BETSY SUSAN GLASER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 12/01/2017
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Provider Practice Location Address
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Address Line | 332 WASHINGTON STREET SUITE 375
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City | WELLESLEY HILLS
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State | MA
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Zip | 02481
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Country | US
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Telephone | 781-431-1173
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Fax |
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Provider Business Mailing Address
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Address Line | 332 WASHINGTON ST STE 375
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City | WELLESLEY HILLS
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State | MA
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Zip | 02481-6215
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Country | US
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Telephone | 617-513-4025
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4813
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License Number State | MA
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