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Organization

MIND IN BLOOM PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHERINE GORNCY (OWNER)
(313) 356-6878
Entity
Organization

Contact information

Practice address
504 E 4TH ST, ROYAL OAK, MI 48067-2847
(313) 356-6878
Mailing address
504 E 4TH ST, ROYAL OAK, MI 48067-2847

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
05/24/2023
Last updated
05/24/2023
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