Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PY6981 | FL |
N | 103TC0700X | Clinical Psychologist | PY6981 | FL |
Y | 102L00000X | Psychologist | PY6981 | FL |
Y | 103T00000X | Psychologist | PY6981 | FL |
NPI | 1003981986 |
---|---|
Provider Name | Dr. Michael Alan Charash |
First Address | Lady Lake, FL 32159-8305 |
Second Address | Arcadia, FL 34266-8752 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2006 |
Last Update Date | 28/04/2020 |