Provider Demographics
NPI:1316660772
Name:GLAZER, VALERIE KIM (LIFESTYLE COACH)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:KIM
Last Name:GLAZER
Suffix:
Gender:F
Credentials:LIFESTYLE COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5202 NOBLE AVE APT 207
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-3917
Mailing Address - Country:US
Mailing Address - Phone:818-679-7294
Mailing Address - Fax:
Practice Address - Street 1:14500 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4190
Practice Address - Country:US
Practice Address - Phone:818-714-2066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator