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General NPI Number Information
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NPI Number | 1760043376
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Entity Type | Individual
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Provider Name | BOB STOVER LMSW
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Gender | Male
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 500 MARKAVIEW RD NW
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City | HUNTSVILLE
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State | AL
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Zip | 35805-3652
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Country | US
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Telephone | 256-535-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 1003 HEIGHTS TRAIL SE APT #121
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City | BROWNSBORO
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State | AL
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Zip | 35741
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Country | US
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Telephone | 850-510-2278
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 11931
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License Number State | TN
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