Provider Demographics
NPI:1952657314
Name:GLOVER, TRUDY ANNA (COTA)
Entity Type:Individual
Prefix:
First Name:TRUDY
Middle Name:ANNA
Last Name:GLOVER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11850 9TH ST N
Mailing Address - Street 2:APT 20208
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1619
Mailing Address - Country:US
Mailing Address - Phone:904-305-1912
Mailing Address - Fax:
Practice Address - Street 1:11850 9TH STREET NORTH
Practice Address - Street 2:APT 20208
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716
Practice Address - Country:US
Practice Address - Phone:727-345-2775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant