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General NPI Number Information
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NPI Number | 1992040133
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Entity Type | Individual
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Provider Name | MICHAEL N. GHALI PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/28/2012
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 1115 ELKTON DR STE 102
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-3597
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Country | US
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Telephone | 719-357-6471
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Fax | 719-434-9811
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Provider Business Mailing Address
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Address Line | 6140 ASHTON PARK PL
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-4810
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Country | US
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Telephone | 239-560-2785
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Fax | 239-561-9779
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY 8141
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License Number State | FL
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