Organization
BLOOM PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOLLY MICHELLE SPOTTS PSY.D. (OWNER)
(228) 547-2273
Entity
Organization
Contact information
Practice address
1520 29TH AVE, SUITE 31, GULFPORT, MS 39501-2843
(228) 547-2273
Mailing address
PO BOX 1583, LONG BEACH, MS 39560-1583
(228) 547-2273
(877) 895-6469
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
54965
MS
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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