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Individual

CHAD THOMAS BOUSAMRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
1105 E EIGHTH ST, TRAVERSE CITY, MI 49686-2936
(231) 935-6787
(231) 935-6920
Mailing address
1105 E EIGHTH ST, TRAVERSE CITY, MI 49686-2936
(231) 935-6787
(231) 935-6920

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6401010758
MI

Other

Enumeration date
03/31/2008
Last updated
03/31/2008
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