Individual
PAULETTE GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4521 BUFORT BLVD, HUBER HEIGHTS, OH 45424-5583
(937) 397-5963
Mailing address
4521 BUFORT BLVD, HUBER HEIGHTS, OH 45424-5583
(937) 397-5963
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5718526
—
OH
Enumeration date
11/16/2020
Last updated
11/16/2020
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