Individual
CARLY GRENNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
202 HOWARD ST, AUBURNDALE, FL 33823-3431
(863) 551-3300
Mailing address
PO BOX 1057, LAKE ALFRED, FL 33850-1057
(863) 551-3300
(863) 551-3301
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-21181
FL
Other
Enumeration date
02/18/2016
Last updated
02/18/2016
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