Most Relevant Information
Provider Data
| NPI Number: | 1003214487 |
| Provider Name: | TARA GLAVIN MA, BCBA |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | 1-08-4015 |
Most Important Dates
| Enumeration Date: | 12/16/2014 |
| Last Updated: | 12/16/2014 |
Provider Practice Location
1420 W GRAND AVE
UNIT 2
CHICAGO
IL
606428873
Practice Location Phone/Fax
| Phone: | 8474777729 |
| Fax: |
Provider Mailing Location
1420 W GRAND AVE
UNIT 2
CHICAGO
IL
606428873
Provider Mailing Phone/Fax
| Phone: | 8474777729 |
| Fax: |