Mgglenn Etienne

NPI #1588176705 in Columbus, Ohio

Provider Information

NPI Number: 1588176705
Entity Type: Individual
Name: Mgglenn Etienne
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Oct 27, 2017
Last Updated: Oct 27, 2017

Practice Location

Address: 2540 BILLINGSLEY RD
City: Columbus
State: Ohio
ZIP Code: 43235-1990
Phone: (614) 602-6475

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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