Provider Demographics
NPI:1609651389
Name:GLATZ, JENNIFER D (AUD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:D
Last Name:GLATZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11220 ELM LN STE 207
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-0450
Mailing Address - Country:US
Mailing Address - Phone:956-630-7629
Mailing Address - Fax:855-888-9196
Practice Address - Street 1:5425 N MCCOLL RD STE A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2249
Practice Address - Country:US
Practice Address - Phone:956-630-7629
Practice Address - Fax:855-888-9196
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81224231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter