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Individual

NATHAN BULTMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, LLMFT

Contact information

Practice address
6630 GRAN VIA CT NE, ROCKFORD, MI 49341-9692
(616) 240-3023
Mailing address
6630 GRAN VIA CT., ROCKFORD, MI 49341-9692
(616) 240-3023

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401011996
MI
106H00000X
Marriage & Family Therapist
4101006529
MI

Other

Enumeration date
09/19/2013
Last updated
09/19/2013
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