Provider Demographics
NPI:1679698591
Name:GLOVER, EMILY BAKER (LICSW)
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:BAKER
Last Name:GLOVER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:2 EXECUTIVE PARK DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6915
Mailing Address - Country:US
Mailing Address - Phone:512-406-7239
Mailing Address - Fax:866-535-6974
Practice Address - Street 1:2 EXECUTIVE PARK DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6915
Practice Address - Country:US
Practice Address - Phone:512-406-7239
Practice Address - Fax:866-535-6974
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1133591041C0700X
RIISW018301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical