Individual
DR. MAXWELL MIKELIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
123 S BROAD ST STE 2240, PHILADELPHIA, PA 19109-1029
(267) 209-0140
Mailing address
123 S BROAD ST STE 2240, PHILADELPHIA, PA 19109-1029
(267) 209-0140
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS020807
PA
Other
Enumeration date
07/28/2026
Last updated
07/28/2026
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