Provider Demographics
NPI:1518766872
Name:GLAMORE, REGINA (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:GLAMORE
Suffix:
Gender:
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7675 OAK RIDGE HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-3336
Mailing Address - Country:US
Mailing Address - Phone:865-253-7077
Mailing Address - Fax:865-253-7906
Practice Address - Street 1:7675 OAK RIDGE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-3336
Practice Address - Country:US
Practice Address - Phone:865-253-7077
Practice Address - Fax:865-253-7906
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1809103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst