Provider Information for 1295104941
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VANESSA ANNE GLATT LPCC
Sex: Female
NPI: 1295104941
Last Updated: 2021-01-22
Certification Date: 2021-01-15
Certification Date: 2021-01-15
Details
Name | Value | ||||||||||||
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NPI | 1295104941 | ||||||||||||
Enumeration Date | 2015-09-23 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | NO | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 2644 30TH ST SANTA MONICA, CA 90405-3060 United States Phone: 310-314-6200 | Fax: | ||||||||||||
Primary Practice Address | 2644 30TH ST SANTA MONICA, CA 90405-3060 United States Phone: 310-314-6200 | Fax: | ||||||||||||
Secondary Practice Address(es) | 2369 109TH AVE NW | ||||||||||||
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