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NPI Code Detail

MEDICARE: ANNETTE K KOLB LMSW

MEDICARE: ANNETTE K KOLB LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801080742MI

General Provider Information

NPI Number : 1457480436
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNETTE K KOLB LMSW
Provider Business Mailing Address
First Line : 2303 KALAMAZOO AVE SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507-3780
Country : US
Telephone Number : 616-965-8390
Fax Number : 616-233-0689
Provider Business Practice Location Address
First Line : 2303 KALAMAZOO AVE SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507-3780
Country : US
Telephone Number : 616-965-8390
Fax Number : 616-233-0689
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 04/11/2024

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Directions to “ ANNETTE K KOLB LMSW” Practice Location

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