Provider Demographics
NPI:1447517081
Name:MAGLIONE-GLASER, TERESA ANNE (IBCLC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:ANNE
Last Name:MAGLIONE-GLASER
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3561 NW 33RD PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-2001
Mailing Address - Country:US
Mailing Address - Phone:352-317-1771
Mailing Address - Fax:
Practice Address - Street 1:810 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-5507
Practice Address - Country:US
Practice Address - Phone:352-317-1771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIBCLC10016642163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant