Individual
MS. ERICA BOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
19401 NORTHLINE RD, SOUTHGATE, MI 48195-2277
(734) 785-7718
Mailing address
19401 NORTHLINE RD, SOUTHGATE, MI 48195-2277
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801091442
MI
Other
Enumeration date
06/03/2009
Last updated
12/02/2009
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