Doctor Name: | PATRICE GLOVER |
NPI Number: | 1316368319 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CCC-SLP |
License Number: | SLP008297 |
Business Practice Address: | 545 Old Norcross Road Suite 100 Lawrenceville, GA - 300463390 |
Business Phone Number: | 6783772833 |
Business Fax Number: | 6783772882 |
Mailing Address: | Po Box 78042, ATLANTA |
State: | GA |
Postal Code: | 303572042 |
Phone Number: | 8318695799 |
Fax Number: | |
NPI Enumeration Date: | 12/18/2013 |
NPI Last Update Date: | 12/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP008297 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |