Individual
DR. MICHAEL BOMBARDIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
660 KENILWORTH DR, SUITE 101, BALTIMORE, MD 21204-2313
(410) 583-5377
Mailing address
660 KENILWORTH DR, SUITE 101, TOWSON, MD 21204-2313
(512) 694-0215
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
05349
MD
Other
Enumeration date
11/04/2013
Last updated
04/22/2015
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