Individual
MISS AUTUMN NICOLE GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
150 N MILLER RD STE 150A, FAIRLAWN, OH 44333-3713
(330) 867-2240
Mailing address
150 N MILLER RD STE 150A, FAIRLAWN, OH 44333-3713
(330) 867-2240
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-82172
OH
Other
Enumeration date
10/09/2025
Last updated
10/09/2025
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