Doctor Name: | JANIS GLOTKOWSKI |
NPI Number: | 1013301332 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, TLLP |
License Number: | 6301016208 |
Business Practice Address: | 1777 Axtell Dr Suite 100 Troy, MI - 480844404 |
Business Phone Number: | 2486135377 |
Business Fax Number: | |
Mailing Address: | 1777 Axtell Dr, Suite 100 TROY |
State: | MI |
Postal Code: | 480844404 |
Phone Number: | 2486135377 |
Fax Number: | |
NPI Enumeration Date: | 03/25/2015 |
NPI Last Update Date: | 03/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6301016208 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |