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Individual

KRISTA GAIL GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
125 REARDON BLVD, BARDSTOWN, KY 40004-2034
(800) 701-0498
Mailing address
2120 CONCORDIA RD, PAYNEVILLE, KY 40157-7621

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-26-5122640
KY

Other

Enumeration date
02/04/2026
Last updated
02/04/2026
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