Wurglitz, Glen M

Wurglitz, Glen M is an sole proprietor health care provider with primary practice located at 14780 W Mountain View Blvd Ste 210 , Surprise AZ 85374-7281. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Wurglitz, Glen M can be contacted via phone (630) 360-7309.

Contact Information

Primary practice address
14780 W Mountain View Blvd Ste 210 Surprise AZ 85374-7281
Phone: (630) 360-7309
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20041231A Indiana
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071005590 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6301015915 Michigan
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY005163 Arizona

Profile Details

NPI number 1932144615
LBN Legal business name Wurglitz, Glen M
Credentials PYSD, HSPP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2006
Last updated Feb 20th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932144615 NPPES
Indiana MEDICAID 200918700

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