Healthcare Provider Details
I. General information
NPI: 1821273061
Provider Name (Legal Business Name): KAREN S SILVERMAN GLICK PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/07/2008
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2400 CHESTNUT ST C/O HARMONY MHS INC.
PHILADELPHIA PA
19103-4316
US
IV. Provider business mailing address
449 RIGHTERS MILL RD
PENN VALLEY PA
19072-1422
US
V. Phone/Fax
- Phone: 215-568-5900
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | PS-006895-L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: