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NPI Code Detail

MEDICARE: COURTNEY GLASSER

MEDICARE: COURTNEY GLASSER
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
1106S00000XBehavior TechnicianRBT-20-113945ND

General Provider Information

NPI Number : 1528692316
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY GLASSER
Provider Business Mailing Address
First Line : 1929 N WASHINGTON ST STE GG
Second Line :
City : BISMARCK
State : ND
Zip : 58501-1669
Country : US
Telephone Number : 701-751-2315
Fax Number :
Provider Business Practice Location Address
First Line : 1929 N WASHINGTON ST STE GG
Second Line :
City : BISMARCK
State : ND
Zip : 58501-1669
Country : US
Telephone Number : 701-751-2315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2020
Last Update Date : 03/02/2020

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Directions to “ COURTNEY GLASSER ” Practice Location

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