Individual
MS. AMBER DANIELLE GLANTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9115 SW OLESON RD, PORTLAND, OR 97223-6875
(971) 236-0915
Mailing address
2621 NE 131ST CT, VANCOUVER, WA 98684-6428
(925) 813-4823
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XEH903730019
BLUE SHEILD
CA
Enumeration date
06/04/2018
Last updated
05/20/2020
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