Individual
JONATHAN LAWRENCE LUNDBLAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
30150 TELEGRAPH RD STE 245, BINGHAM FARMS, MI 48025-4521
(800) 693-1916
Mailing address
30150 TELEGRAPH RD STE 245, BINGHAM FARMS, MI 48025-4521
(313) 889-4321
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6362009597
MI
Other
Enumeration date
11/13/2023
Last updated
11/12/2025
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