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Individual
MICHAEL L BOURGOISE
Active
Individual
MICHAEL L BOURGOISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW-C, CAADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C-04880
MI
1041C0700X
Clinical Social Worker
Primary
6801114610
MI
Other
Enumeration date
09/24/2020
Last updated
05/21/2023
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