| Wild Blooms Therapy Llc | |
|
5840 N Canton Center Rd Ste 282 Canton MI 48187-2614 | |
| (734) 905-0940 | |
| (734) 357-0766 |
| Full Name | Wild Blooms Therapy Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 5840 N Canton Center Rd Ste 282, Canton, Michigan |
| Authorized Official Name and Position | Nausheen Masood (DIRECTOR) |
| Authorized Official Contact | 7347094259 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Blooms Therapy Llc 5840 N Canton Center Rd Ste 282 Canton MI 48187-2614 Ph: (734) 905-0940 | Wild Blooms Therapy Llc 5840 N Canton Center Rd Ste 282 Canton MI 48187-2614 Ph: (734) 905-0940 |
| NPI Number | 1811554470 |
|---|---|
| Provider Enumeration Date | 05/20/2019 |
| Last Update Date | 02/10/2021 |
| Certification Date | 02/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811554470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TA0700X | Psychologist - Adult Development & Aging | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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