Provider Demographics
NPI:1043701600
Name:GLAZER, ADRIANA YODFAT (LISW)
Entity type:Individual
Prefix:MS
First Name:ADRIANA
Middle Name:YODFAT
Last Name:GLAZER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45015-1135
Mailing Address - Country:US
Mailing Address - Phone:513-868-4882
Mailing Address - Fax:513-868-1415
Practice Address - Street 1:2250 PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45015-1135
Practice Address - Country:US
Practice Address - Phone:513-868-4882
Practice Address - Fax:513-868-1415
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.20022981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0290158Medicaid