Jenna Glass
Behavior Technician in Lithia, FL. Individual provider (NPI-1).
NPI number1902529068
StatusActive
Last updated in NPPESSep 23, 2022
Details
- NPI
- 1902529068
- Entity type
- Individual (NPI-1)
- Name
- Jenna Glass
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 23, 2022
- Certification date
- Sep 23, 2022
- Last updated
- Sep 23, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
5454 Lithia Pinecrest RdLithia, FL 33547-2853
Phone 813-467-9280
Mailing address
300 International Pkwy Ste 200Lake Mary, FL 32746-5028
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