Provider Demographics
NPI:1689900987
Name:MACLEAN, BRUCE MILLER (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:MILLER
Last Name:MACLEAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10818 COLONY WOOD PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1310
Mailing Address - Country:US
Mailing Address - Phone:281-367-8662
Mailing Address - Fax:281-586-5901
Practice Address - Street 1:2180 NORTH LOOP WEST
Practice Address - Street 2:SUITE 320
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018
Practice Address - Country:US
Practice Address - Phone:832-384-1560
Practice Address - Fax:832-384-1585
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00260101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor