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MR. KENNETH LENSFORD GLOVER I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CDC2

Contact information

Practice address
64 2ND AVE, ALBANY, NY 12202-1240
(518) 449-5170
Mailing address
15A OLD HICKORY DR APT 1B, ALBANY, NY 12204-1129
(518) 330-5544

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
12/03/2013
Last updated
12/03/2013
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