Individual
COLLEEN ELIZABETH GLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
48 SALEM ST, WAKEFIELD, MA 01880-1838
(978) 810-5858
Mailing address
48 SALEM ST, WAKEFIELD, MA 01880-1838
(978) 810-5858
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100203282189
—
MA
Enumeration date
03/02/2021
Last updated
03/02/2021
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