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Individual

GLENN STEVEN ASHKANAZI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0294
(352) 265-0096
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 265-0294
(352) 265-0096

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY5365
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
211997800
FL
Enumeration date
07/30/2006
Last updated
10/02/2008
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