Individual
ERICA LYNN GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14415 US HIGHWAY 23, WAVERLY, OH 45690-9372
(740) 970-1425
Mailing address
5308 LONG FORK RD, PIKETON, OH 45661-9774
(740) 970-1425
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203608
—
OH
Enumeration date
01/28/2021
Last updated
01/28/2021
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