| NPI | 1689089229 |
|---|---|
| Former Name | MICHELLE GLICKMAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS019712) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: PA PC011819) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2025-05-06 |