Provider Demographics
NPI:1710158910
Name:THE GLOVER GROUP
Entity Type:Organization
Organization Name:THE GLOVER GROUP
Other - Org Name:RED WAGON CHILDREN'S THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JO
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:512-680-6782
Mailing Address - Street 1:6507 JESTER BLVD
Mailing Address - Street 2:BUILDING 3, SUITE 309
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-8368
Mailing Address - Country:US
Mailing Address - Phone:512-680-6782
Mailing Address - Fax:
Practice Address - Street 1:6507 JESTER BLVD
Practice Address - Street 2:BUILDING 3, SUITE 309
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-8368
Practice Address - Country:US
Practice Address - Phone:512-680-6782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty