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NPI Code Detail

MEDICARE: LEANDRA LYNETTE GLOVER

MEDICARE: LEANDRA LYNETTE GLOVER
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
1106S00000XBehavior TechnicianAR

General Provider Information

NPI Number : 1215882451
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEANDRA LYNETTE GLOVER
Provider Business Mailing Address
First Line : 1000 SWN DR STE 101
Second Line :
City : CONWAY
State : AR
Zip : 72032-2558
Country : US
Telephone Number : 501-328-3274
Fax Number : 501-328-3274
Provider Business Practice Location Address
First Line : 1900 ALDERSGATE RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-6620
Country : US
Telephone Number : 501-821-5459
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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Directions to “ LEANDRA LYNETTE GLOVER ” Practice Location

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