Provider Demographics
NPI:1528874294
Name:GLASS, ALISON (OTD)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:GLASS
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 COUNTY ROAD 473
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:AL
Mailing Address - Zip Code:36453-4695
Mailing Address - Country:US
Mailing Address - Phone:334-378-9258
Mailing Address - Fax:
Practice Address - Street 1:440 HIGHWAY 59 LOOP S STE 104
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-9011
Practice Address - Country:US
Practice Address - Phone:888-328-8148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist