| Kathryn Bultman | |
|
1179 E Paris Ave Se Grand Rapids MI 49546-8371 | |
| (616) 460-1857 | |
| (616) 454-0061 |
| Full Name | Kathryn Bultman |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1179 E Paris Ave Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Kathryn Bultman (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6164601857 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathryn Bultman 2231 Ridgecroft Ave Se Grand Rapids MI 49546-5759 Ph: (616) 460-1857 | Kathryn Bultman 1179 E Paris Ave Se Grand Rapids MI 49546-8371 Ph: (616) 460-1857 |
| NPI Number | 1124120670 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124120670 | NPI | - | NPPES |
| 1316972706 | Other | MI | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801082187 (Michigan) | Primary |
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