Most Relevant Information
Provider Data
| NPI Number: | 1003663881 |
| Provider Name: | GLENNA MARIE HOLM |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/01/2024 |
| Last Updated: | 05/21/2024 |
Provider Practice Location
1530 S SHIELDS DR
WAUKEGAN
IL
600858307
Practice Location Phone/Fax
| Phone: | 8772701812 |
| Fax: |
Provider Mailing Location
10912 75TH ST APT 102
KENOSHA
WI
531428405
Provider Mailing Phone/Fax
| Phone: | 2629603983 |
| Fax: |