Organization
MICHELLE M. BISHOP, PHD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA ROSE (OFFICE MANAGER)
(352) 331-0020
Entity
Organization
Contact information
Practice address
2653 SW 87TH DR STE A, GAINESVILLE, FL 32608-9313
(352) 331-0020
(352) 331-0022
Mailing address
2653 SW 87TH DR STE A, GAINESVILLE, FL 32608-9313
(352) 331-0020
(352) 331-0022
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY6140
FL
103TC0700X
Clinical Psychologist
Primary
PY6140
FL
103TH0100X
Health Service Psychologist
PY6140
FL
Other
Enumeration date
11/10/2009
Last updated
11/10/2009
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