Provider Demographics
NPI:1447962089
Name:GLOVER, ROBBIE O'NEAL
Entity type:Individual
Prefix:MR
First Name:ROBBIE
Middle Name:O'NEAL
Last Name:GLOVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 RELIANCE RD
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-8354
Mailing Address - Country:US
Mailing Address - Phone:304-703-6856
Mailing Address - Fax:
Practice Address - Street 1:3094 CHARLES TOWN RD
Practice Address - Street 2:
Practice Address - City:KEARNEYSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25430-2669
Practice Address - Country:US
Practice Address - Phone:304-901-2070
Practice Address - Fax:304-885-1054
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2781101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional