Individual
JACOB ALAN BOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6852093221
MI
106S00000X
Behavior Technician
—
MI
Other
Enumeration date
06/26/2020
Last updated
02/24/2023
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