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General NPI Number Information
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NPI Number | 1205073913
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Entity Type | Organization
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Legal Business Name | BC PRICE PROFESSIONAL SERVICES LLC
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 230 MICHIGAN ST NE STE# 102
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2550
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Country | US
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Telephone | 616-540-7089
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Fax |
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Provider Business Mailing Address
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Address Line | 2422 ABBINGTON DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-5402
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Country | US
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Telephone | 616-540-7089
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARBARA CLAYTON PRICE
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Credential | MSW
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Telephone | 616-540-7089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801065990
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License Number State | MI
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