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Individual

JERRIEN D BONNEMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
2215 44TH ST SW, WYOMING, MI 49519-6439
(616) 252-8371
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801067428
MI

Other

Enumeration date
10/29/2008
Last updated
10/29/2008
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