Organization
MICHAEL R. GILDEA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL RICHARD GILDEA M.S.ED., LPC, CAC (OWNER/THERAPIST)
(570) 522-8330
Entity
Organization
Contact information
Practice address
88 N BULL RUN XING, SUITE 6, LEWISBURG, PA 17837-6725
(570) 522-8330
Mailing address
88 N BULL RUN XING, SUITE 6, LEWISBURG, PA 17837-6725
(570) 522-8330
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
607049
PA
Other
Enumeration date
08/16/2007
Last updated
08/16/2007
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