| Doctor Name: | KEITH GLOVER |
| NPI Number: | 1114122389 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MDIV, STM, LPC |
| License Number: | 386 |
| Business Practice Address: | 12335 Wake Union Church Rd Ste 206 Wake Forest, NC - 275874527 |
| Business Phone Number: | 9195621080 |
| Business Fax Number: | |
| Mailing Address: | 5317 Cypress Ln, RALEIGH |
| State: | NC |
| Postal Code: | 276094109 |
| Phone Number: | 9198765894 |
| Fax Number: | |
| NPI Enumeration Date: | 06/18/2007 |
| NPI Last Update Date: | 10/05/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | 386 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |