Provider Demographics
NPI:1750684429
Name:GLOVER, LAUREEN ALICIA (MA)
Entity Type:Individual
Prefix:MRS
First Name:LAUREEN
Middle Name:ALICIA
Last Name:GLOVER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1708 LEXINGTON GREEN LN
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1018
Mailing Address - Country:US
Mailing Address - Phone:407-413-9550
Mailing Address - Fax:866-610-0580
Practice Address - Street 1:1708 LEXINGTON GREEN LN
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1018
Practice Address - Country:US
Practice Address - Phone:407-413-9550
Practice Address - Fax:866-610-0580
Is Sole Proprietor?:No
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst