Individual
COLLEEN BULLARD VANSLAMBROUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8575 2ND ST, MATTAWAN, MI 49071-9409
(269) 375-0372
Mailing address
8575 2ND ST, MATTAWAN, MI 49071-9409
(269) 375-0372
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801019874
MI
Other
Enumeration date
08/17/2011
Last updated
08/17/2011
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