Healthcare Provider Details

I. General information

NPI: 1083528269
Provider Name (Legal Business Name): HOLLY BETH BODJANAC-REINHART MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 N FRONT ST
MARQUETTE MI
49855-3527
US

IV. Provider business mailing address

530 E HEWITT AVE
MARQUETTE MI
49855-3716
US

V. Phone/Fax

Practice location:
  • Phone: 906-225-5330
  • Fax:
Mailing address:
  • Phone: 906-275-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6801115640
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: