Provider Demographics
NPI:1649694225
Name:LYNN K GLOVER INC
Entity type:Organization
Organization Name:LYNN K GLOVER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:K
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, SLP-CCC
Authorized Official - Phone:972-342-5119
Mailing Address - Street 1:16990 DALLAS PARKWAY
Mailing Address - Street 2:SUITE 255
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1997
Mailing Address - Country:US
Mailing Address - Phone:972-342-5119
Mailing Address - Fax:
Practice Address - Street 1:16990 DALLAS PARKWAY
Practice Address - Street 2:SUITE 255
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1997
Practice Address - Country:US
Practice Address - Phone:972-342-5119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108443235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1073937058OtherNPI1
1073937058OtherNPI1