MEDICARE: DR. TERRE GLAHN PH.D., BCBA-D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1598195018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRE GLAHN PH.D., BCBA-D

Provider Business Mailing Address
First Line	:	4424 E CERRADA DEL CHARRO
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-6158
Country	:	US
Telephone Number	:	385-229-7379
Fax Number	:

Provider Business Practice Location Address
First Line	:	4424 E CERRADA DEL CHARRO
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-6158
Country	:	US
Telephone Number	:	385-229-7379
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2013
Last Update Date	:	11/29/2016

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