Individual
GLEN ARIEL ILUNGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
2003 CHEATHAM WOODS DR SW, MARIETTA, GA 30008-4451
(678) 672-0068
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-60214
GA
106S00000X
Behavior Technician
RBT-18-60097
GA
Other
Enumeration date
04/14/2020
Last updated
06/27/2025
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