Provider Demographics
NPI:1588865786
Name:GLAZE, RACHELLE ULANA (BA)
Entity type:Individual
Prefix:MS
First Name:RACHELLE
Middle Name:ULANA
Last Name:GLAZE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 WILLOWBROOK DR SE APT 4
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-3814
Mailing Address - Country:US
Mailing Address - Phone:256-881-4457
Mailing Address - Fax:
Practice Address - Street 1:9238 MADISON BLVD BLDG 1 SUITE 1300
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9100
Practice Address - Country:US
Practice Address - Phone:256-774-8340
Practice Address - Fax:256-774-8380
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor