Organization
MINDBLOOM PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW R MACLELLAN MA, LLP, QIDP (PSYCHOTHERAPIST)
(734) 812-8541
Entity
Organization
Contact information
Practice address
53473 TUNDRA DR, SHELBY TOWNSHIP, MI 48316-2164
(734) 812-8541
Mailing address
53473 TUNDRA DR, SHELBY TOWNSHIP, MI 48316-2164
(734) 812-8541
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
07/22/2022
Last updated
07/22/2022
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