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General NPI Number Information
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NPI Number | 1639874043
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Entity Type | Individual
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Provider Name | JUANITA GLOVER OTA/L
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Gender | Female
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 3902 WOODWORTH DR
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City | LORAIN
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State | OH
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Zip | 44053-1187
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Country | US
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Telephone | 212-162-5527
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Fax | 440-538-3006
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Provider Business Mailing Address
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Address Line | 3902 WOODWORTH DR
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City | LORAIN
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State | OH
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Zip | 44053-1187
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Country | US
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Telephone | 216-255-2764
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Fax | 444-405-3830
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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