Individual
SARAH GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3482 MCCLURE AVE, WEST LAFAYETTE, IN 47906-4164
(765) 838-3547
Mailing address
3482 MCCLURE AVE, WEST LAFAYETTE, IN 47906-4164
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-34087
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-18-34087
BCBA
—
Enumeration date
11/05/2019
Last updated
11/05/2019
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