Most Relevant Information
Provider Data
| NPI Number: | 1003468802 |
| Provider Name: | MICHELE GLAZE |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/11/2019 |
| Last Updated: | 07/11/2019 |
Provider Practice Location
904 HIGHWAY 20
THIBODAUX
LA
703016235
Practice Location Phone/Fax
| Phone: | 9854141015 |
| Fax: |
Provider Mailing Location
904 HIGHWAY 20
THIBODAUX
LA
703016235
Provider Mailing Phone/Fax
| Phone: | 9854141015 |
| Fax: |