Individual
KAREN GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
32 N WASHINGTON ST, ARDMORE, OK 73401-7013
(580) 224-9845
Mailing address
PO BOX 48, MEAD, OK 73449-0048
(580) 745-9610
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100708380A
—
OK
05
—
200049040
—
OK
Enumeration date
06/27/2012
Last updated
06/27/2012
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