Individual
MICHAEL D GLEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
235 NORTH AVE, PENN YAN, NY 14527-1051
(315) 536-7447
Mailing address
3300 E LAKE RD UNIT 7C, CANANDAIGUA, NY 14424-2353
(315) 415-5465
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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