Individual
AMY JANE-BOLT MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
605 HOWARD ST, KALAMAZOO, MI 49008-1919
(269) 329-8297
(269) 387-7050
Mailing address
1000 OAKLAND DR, 3RD FLOOR CTAC, KALAMAZOO, MI 49008-1282
(269) 329-8297
(269) 387-7050
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6901089181
MI
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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