Individual
MR. JEFFREY ALAN BOOTZIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDS, LLP
Contact information
Practice address
330 EASTERN AVE SE, GRAND RAPIDS, MI 49503-4737
(616) 776-0891
(616) 233-0672
Mailing address
330 EASTERN AVE SE, GRAND RAPIDS, MI 49503
(616) 776-0891
(616) 233-0672
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301002673
MI
Other
Enumeration date
09/30/2008
Last updated
09/30/2008
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