Individual
BRENDAN TREVOR TEAGUE-GLOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
508 UPLAND ST, KENAI, AK 99611-8026
(907) 335-7500
Mailing address
508 UPLAND ST, KENAI, AK 99611-8026
(907) 335-7500
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
AK
106S00000X
Behavior Technician
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1751783
—
AK
Enumeration date
01/03/2023
Last updated
06/19/2025
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