Individual
MRS. MICHELLE BOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLADC
Contact information
Practice address
2112 W FAIDLEY AVE, GRAND ISLAND, NE 68803-4670
(308) 398-5895
Mailing address
PO BOX 92, ALDA, NE 68810-0092
(308) 850-6426
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P-2175
NE
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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