Provider Demographics
NPI:1073199352
Name:GLOVER, REBECCA PRATT (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:PRATT
Last Name:GLOVER
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3641 PARTRIDGE PATH APT 6
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2446
Mailing Address - Country:US
Mailing Address - Phone:734-707-5857
Mailing Address - Fax:
Practice Address - Street 1:1600 COMMERCE PARK DR STE 300
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1620
Practice Address - Country:US
Practice Address - Phone:734-433-0699
Practice Address - Fax:734-433-1307
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601001009231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist