| Sally Bloch Phd Lp Pllc | |
|
4190 Telegraph Rd Ste 2700 Bloomfield Hills MI 48302-2042 | |
| (248) 343-3318 | |
| (248) 522-7365 |
| Full Name | Sally Bloch Phd Lp Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 4190 Telegraph Rd Ste 2700, Bloomfield Hills, Michigan |
| Authorized Official Name and Position | Sally Ann Bloch (PSYCHOLOGIST) |
| Authorized Official Contact | 2483433318 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sally Bloch Phd Lp Pllc 939 Rivenoak St Birmingham MI 48009-5737 Ph: (248) 343-3318 | Sally Bloch Phd Lp Pllc 4190 Telegraph Rd Ste 2700 Bloomfield Hills MI 48302-2042 Ph: (248) 343-3318 |
| NPI Number | 1801069323 |
|---|---|
| Provider Enumeration Date | 04/04/2008 |
| Last Update Date | 06/25/2020 |
| Certification Date | 06/25/2020 |
| Medicare PECOS PAC ID | 1153479506 |
|---|---|
| Medicare Enrollment ID | O20090423000474 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801069323 | NPI | - | NPPES |
| 0F32753 | Other | MI | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301006311 (Michigan) | Primary |
| Provider Name | Sally A Bloch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598842908 PECOS PAC ID: 9436207883 Enrollment ID: I20090423000463 |
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