Healthcare Provider Details

I. General information

NPI: 1801925144
Provider Name (Legal Business Name): IRA PAUL GLOVINSKY PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2007
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 PLYMOUTH RD STE 203
ANN ARBOR MI
48105-3205
US

IV. Provider business mailing address

2001 PAULINE CT
ANN ARBOR MI
48103-5185
US

V. Phone/Fax

Practice location:
  • Phone: 734-741-1532
  • Fax:
Mailing address:
  • Phone: 734-741-1532
  • Fax: 248-538-1558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301002575
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: