| Mind In Bloom Pllc | |
|
504 E 4th St Royal Oak MI 48067-2847 | |
| (313) 356-6878 | |
| Not Available |
| Full Name | Mind In Bloom Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 504 E 4th St, Royal Oak, Michigan |
| Authorized Official Name and Position | Katherine Gorncy (OWNER) |
| Authorized Official Contact | 3133566878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind In Bloom Pllc 504 E 4th St Royal Oak MI 48067-2847 Ph: () - | Mind In Bloom Pllc 504 E 4th St Royal Oak MI 48067-2847 Ph: (313) 356-6878 |
| NPI Number | 1134811318 |
|---|---|
| Provider Enumeration Date | 05/24/2023 |
| Last Update Date | 05/24/2023 |
| Certification Date | 05/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134811318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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