MEDICARE: RICHARD XAVIER GLOSSER

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	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1306460381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD XAVIER GLOSSER

Provider Business Mailing Address
First Line	:	708 ROSEWOOD DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15239-1065
Country	:	US
Telephone Number	:	412-977-8699
Fax Number	:

Provider Business Practice Location Address
First Line	:	708 ROSEWOOD DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15239-1065
Country	:	US
Telephone Number	:	412-977-8699
Fax Number	:

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

Provider Enumeration Date	:	06/04/2020
Last Update Date	:	06/04/2020

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Directions to “ RICHARD XAVIER GLOSSER ” Practice Location

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