Provider Demographics
NPI:1487244497
Name:GLORIO, AMANDA PALMIRA (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:PALMIRA
Last Name:GLORIO
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16857 CORAL LN
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-1117
Mailing Address - Country:US
Mailing Address - Phone:482-840-4866
Mailing Address - Fax:
Practice Address - Street 1:2189 AVON INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3611
Practice Address - Country:US
Practice Address - Phone:248-726-2286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-23
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-21-53166103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician