Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 5215 | AL |
NPI | 1073153268 |
---|---|
Provider Name | Kaley Howard Glover |
First Address | Montgomery, AL 36117-5406 |
Second Address | Montgomery, AL 36117-5406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2020 |
Last Update Date | 15/01/2020 |