Provider Information for 1023208410
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Dr. TINA MARIE GLOVER PhD, CRC, LPC, LPCC
Sex: Female
NPI: 1023208410
Last Updated: 2024-04-19
Certification Date: 2024-04-15
Certification Date: 2024-04-15
Details
| Name | Value | ||||||||||||||||||||||||||||
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| NPI | 1023208410 | ||||||||||||||||||||||||||||
| Enumeration Date | 2007-07-31 | ||||||||||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||||||||||
| Status | Active | ||||||||||||||||||||||||||||
| Mailing Address | PO BOX 371 CONVERSE, TX 78109-0371 United States Phone: 503-970-0299 | Fax: | ||||||||||||||||||||||||||||
| Primary Practice Address | 2355 STATE ST STE 101 SALEM, OR 97301-4541 United States Phone: 210-503-9834 | Fax:888-371-3076 | ||||||||||||||||||||||||||||
| Secondary Practice Address(es) | 9346 DEVILS RIV 212 N 2ND ST STE 100 212 W TROY ST STE B | ||||||||||||||||||||||||||||
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