Individual
ANDREW J GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2904 FOLTZ DR, EDGEWOOD, KY 41017-2525
(859) 795-3000
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-18-63600
RBT CERTIFICATE
—
Enumeration date
06/28/2019
Last updated
06/28/2019
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