Kathryn Bultman L.L.C.
Social Worker, Clinical in Grand Rapids, MI. Organization (NPI-2).
NPI number1124120670
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1124120670
- Entity type
- Organization (NPI-2)
- Legal business name
- Kathryn Bultman L.L.C.
- Organization subpart
- No
- Enumeration date
- Sep 5, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 6801082187 | MI | Yes |
Other names
- Kathryn Bultman (Other Name)
Practice location
1179 E Paris Ave SeGrand Rapids, MI 49546-8371
Phone 616-460-1857 · Fax 616-454-0061
Mailing address
2231 Ridgecroft Ave SeGrand Rapids, MI 49546-5759
Phone 616-460-1857 · Fax 616-454-0061
Authorized official
Kathryn Bultman
Clinical Social Worker
6164601857
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