Organization
BLUEMIND THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMDALI MAZLOUM (OWNER)
(313) 870-7204
Entity
Organization
Contact information
Practice address
2395 S HURON PKWY, ANN ARBOR, MI 48104-5170
(313) 870-7204
Mailing address
38445 TERRY LN, WESTLAND, MI 48185-7657
(313) 870-7204
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/15/2022
Last updated
08/12/2023
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