| Doctor Name: | MS. CARA M VENUS GLAZE |
| NPI Number: | 1003192006 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LSW |
| License Number: | S1002110 |
| Business Practice Address: | 1560 Fishinger Rd Columbus, OH - 432212108 |
| Business Phone Number: | 6144577876 |
| Business Fax Number: | 6144571040 |
| Mailing Address: | 1560 Fishinger Rd, COLUMBUS |
| State: | OH |
| Postal Code: | 432212108 |
| Phone Number: | 6144577876 |
| Fax Number: | 6144571040 |
| NPI Enumeration Date: | 10/24/2011 |
| NPI Last Update Date: | 10/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | S1002110 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |