Individual
ANDREA LOUIISE GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
91 N SAGINAW ST STE 101, PONTIAC, MI 48342-2165
(248) 254-2616
Mailing address
1141 E MUIR AVE, HAZEL PARK, MI 48030-2628
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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