| Doctor Name: | JONATHAN GLOVER |
| NPI Number: | 1861715690 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CCS |
| License Number: | 603368 |
| Business Practice Address: | 703 W 3rd Ave #b Red Springs, NC - 283771524 |
| Business Phone Number: | 8505150220 |
| Business Fax Number: | 8505150260 |
| Mailing Address: | 1125 Pony Dr, HOPE MILLS |
| State: | NC |
| Postal Code: | 283489159 |
| Phone Number: | 8505150220 |
| Fax Number: | 8505150260 |
| NPI Enumeration Date: | 03/08/2010 |
| NPI Last Update Date: | 08/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 603368 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |