Individual
BETHANY PONICHTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
343 S MAIN ST STE 209B, ANN ARBOR, MI 48104-2137
(248) 259-8540
Mailing address
343 S MAIN ST STE 209B, ANN ARBOR, MI 48104-2137
(734) 418-9180
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801098351
MI
174400000X
Specialist
16241
OR
Other
Enumeration date
01/04/2010
Last updated
04/06/2023
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