Individual
SALLY BLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4190 TELEGRAPH RD STE 2700, BLOOMFIELD HILLS, MI 48302-2042
(248) 343-3318
(248) 522-7365
Mailing address
PO BOX 2257, CHESTERTON, IN 46304-0357
(219) 926-8320
(219) 926-3524
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301006311
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680F327530
BLUE CROSS BLUE SHIELD
MI
Enumeration date
11/01/2006
Last updated
06/23/2011
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