Provider Demographics
NPI:1720550759
Name:GLOVER, MYRA STURGIS (MSW)
Entity Type:Individual
Prefix:
First Name:MYRA
Middle Name:STURGIS
Last Name:GLOVER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6943 BLANCHE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-1305
Mailing Address - Country:US
Mailing Address - Phone:410-382-5488
Mailing Address - Fax:
Practice Address - Street 1:3917 MARKET ST
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:MD
Practice Address - Zip Code:21863-4413
Practice Address - Country:US
Practice Address - Phone:410-382-5488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08626104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker