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PATRICIA SHULL-BLOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LLP

Contact information

Practice address
5148 LOVERS LN, SUITE 200, PORTAGE, MI 49002-1572
(269) 343-3010
(269) 343-3017
Mailing address
5148 LOVERS LN, SUITE 200, PORTAGE, MI 49002-1572
(269) 343-3010
(269) 343-3017

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301010066
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P108918030
BCBSM
MI
Enumeration date
05/11/2006
Last updated
12/14/2015
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