MEDICARE: JENNIFER J GLOVER OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	108981	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8T4322	OTHER	TX	BCBS
2	108981	OTHER	TX	STATE BOARD

General Provider Information

NPI Number	:	1184722282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER J GLOVER OT

Provider Business Mailing Address
First Line	:	6105 CHESTNUT HOLW
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-8201
Country	:	US
Telephone Number	:	512-680-6782
Fax Number	:

Provider Business Practice Location Address
First Line	:	6507 JESTER BLVD
Second Line	:	SUITE 309
City	:	AUSTIN
State	:	TX
Zip	:	78750-8368
Country	:	US
Telephone Number	:	512-680-6782
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	02/20/2008

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Directions to “ JENNIFER J GLOVER OT” Practice Location

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