Provider Demographics
NPI:1326551722
Name:GLOVER, ELIZABETH RAWSON (PSYD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:RAWSON
Last Name:GLOVER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4945 16TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-2359
Mailing Address - Country:US
Mailing Address - Phone:808-388-2162
Mailing Address - Fax:808-388-2162
Practice Address - Street 1:4945 16TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-2359
Practice Address - Country:US
Practice Address - Phone:808-388-2162
Practice Address - Fax:808-388-2162
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI286101YM0800X
FLPY11070103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health