Bloom Psychological Services, LLC

Organization Active NPI Clinical Psychologist · Gulfport, MS

NPI 1083098495 · NPPES record last updated Jul 15, 2015

Key facts

NPI
1083098495
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Psychologist 103TC0700X
License
54965 (MS)
Legal business name
BLOOM PSYCHOLOGICAL SERVICES, LLC
Practice address
1520 29TH Ave
Suite 31
Gulfport, MS 39501-2843
Phone
(228) 547-2273
NPI assigned
Jul 15, 2015
Organization subpart
No

Authorized official

Name
Dr. Holly Michelle Spotts, PSY.D.
Title
Owner
Phone
(228) 547-2273

National Provider Directory

Locations

1520 29th Ave
Ste 31
Gulfport, MS 39501
Phone (228) 547-2273

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist
Group: 193400000X SINGLE SPECIALTY GROUP
103TC0700X 54965 MS Yes

Addresses

Primary practice location

1520 29TH Ave
Suite 31
Gulfport, MS 39501-2843

Mailing address

PO Box 1583
Long Beach, MS 39560-1583
Phone (228) 547-2273

Other providers in Gulfport, MS

All providers in Gulfport, MS · Clinical Psychologist in Mississippi

Sources for this page

Verify at the official NPI Registry.