| Doctor Name: | IAN GLICKMAN |
| NPI Number: | 1144645631 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | |
| Business Practice Address: | 519 Larkins Bridge Dr Downingtown, PA - 193354544 |
| Business Phone Number: | 6104589135 |
| Business Fax Number: | |
| Mailing Address: | 519 Larkins Bridge Dr, DOWNINGTOWN |
| State: | PA |
| Postal Code: | 193354544 |
| Phone Number: | 6104589135 |
| Fax Number: | |
| NPI Enumeration Date: | 02/20/2014 |
| NPI Last Update Date: | 02/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |