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General NPI Number Information
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NPI Number | 1588347371
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Entity Type | Organization
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Legal Business Name | HJB THERAPY, LLC
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Dates
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Enumeration Date | 08/09/2023
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 3181 PRAIRIE ST SW
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City | GRANDVILLE
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State | MI
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Zip | 49418-2097
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Country | US
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Telephone | 616-378-6201
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 HAGUE AVE SW
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City | WYOMING
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State | MI
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Zip | 49519-2335
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Country | US
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Telephone | 616-826-9662
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | HEIDI J NERESON-BOTT
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Credential |
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Telephone | 616-378-6201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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