| Bloom Psychological Services, Llc | |
|
1520 29th Ave Suite 31 Gulfport MS 39501-2843 | |
| (228) 547-2273 | |
| Not Available |
| Full Name | Bloom Psychological Services, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1520 29th Ave, Gulfport, Mississippi |
| Authorized Official Name and Position | Holly Michelle Spotts (OWNER) |
| Authorized Official Contact | 2285472273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Psychological Services, Llc Po Box 1583 Long Beach MS 39560-1583 Ph: (228) 547-2273 | Bloom Psychological Services, Llc 1520 29th Ave Suite 31 Gulfport MS 39501-2843 Ph: (228) 547-2273 |
| NPI Number | 1083098495 |
|---|---|
| Provider Enumeration Date | 07/15/2015 |
| Last Update Date | 07/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083098495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 54965 (Mississippi) | Primary |
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