Individual
STACY GLOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ECDS
Contact information
Practice address
413 W TYLER AVE, WEST MEMPHIS, AR 72301-4149
(870) 735-2737
(870) 551-3724
Mailing address
PO BOX 2192, FORREST CITY, AR 72336-2192
(870) 208-8362
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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