Individual
MS. AMANDA GRACE BOUVRETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21175 15 MILE RD, BIG RAPIDS, MI 49307-8844
(616) 754-6185
(616) 754-6407
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801093041
MI
Other
Enumeration date
07/13/2011
Last updated
10/25/2021
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