Provider Demographics
NPI:1821443078
Name:GLOVER, CARRIE ANN (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANN
Last Name:GLOVER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:MCGLOTHLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:1125 MAGNOLIA DR APT D62
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-2464
Mailing Address - Country:US
Mailing Address - Phone:615-614-3085
Mailing Address - Fax:
Practice Address - Street 1:1125 MAGNOLIA DR APT D62
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-2464
Practice Address - Country:US
Practice Address - Phone:615-614-3085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000740103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst