Provider Demographics
NPI:1710136098
Name:GLOVER, ROBYN L (EDM, PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:L
Last Name:GLOVER
Suffix:
Gender:F
Credentials:EDM, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 MOUNT AUBURN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4656
Mailing Address - Country:US
Mailing Address - Phone:617-547-8100
Mailing Address - Fax:617-812-2663
Practice Address - Street 1:575 MOUNT AUBURN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4656
Practice Address - Country:US
Practice Address - Phone:617-547-8100
Practice Address - Fax:617-812-2663
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9407103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent