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Organization
KATHRYN BULTMAN L.L.C.
Active
Organization
KATHRYN BULTMAN L.L.C.
Active
Other names
Kathryn Bultman
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHRYN BULTMAN LMSW (CLINICAL SOCIAL WORKER)
(616) 460-1857
Entity
Organization
Contact information
Practice address
1179 E PARIS AVE SE, GRAND RAPIDS, MI 49546-8371
(616) 460-1857
(616) 454-0061
Mailing address
2231 RIDGECROFT AVE SE, GRAND RAPIDS, MI 49546-5759
(616) 460-1857
(616) 454-0061
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801082187
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316972706
INDIVIDUAL NPI
MI
Enumeration date
09/05/2006
Last updated
08/22/2020
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