Organization
MB PSYCHOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA BERGQUIST, L BERGQUIST CLINICAL PSYCHOLOGIS (OWNER)
(716) 481-6259
Entity
Organization
Contact information
Practice address
40 GARDENVILLE PKWY STE 112, WEST SENECA, NY 14224-1387
(716) 794-4054
(716) 794-4054
Mailing address
40 GARDENVILLE PKWY STE 112, WEST SENECA, NY 14224-1387
(716) 794-4054
(716) 794-4054
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/08/2023
Last updated
08/08/2023
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