BERGAN JOHANNA BOLTHOUSE

WYOMING, MI
NPI1740175512
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MI  6851120274)
Enumeration Date2025-06-11
Last Update Date2025-06-11
Business Address
BERGAN JOHANNA BOLTHOUSE
1055 GEZON PKWY SW
WYOMING, MI 49509-9542
Phone number: 616-773-2908
Mailing Address
BERGAN JOHANNA BOLTHOUSE
180 HERON DR NW APT 203F
GRAND RAPIDS, MI 49534-1587
Phone number: 616-915-1485
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