Cory William Glad
Behavior Technician in Minneapolis, MN. Individual provider (NPI-1).
NPI number1194474841
StatusActive
Last updated in NPPESMar 21, 2022
Details
- NPI
- 1194474841
- Entity type
- Individual (NPI-1)
- Name
- Cory William Glad
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2022
- Certification date
- Mar 21, 2022
- Last updated
- Mar 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
3333 University Ave SeMinneapolis, MN 55414-3325
Phone 612-720-5530
Mailing address
3333 University Ave SeMinneapolis, MN 55414-3325
Phone 612-720-5530
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