Thea Bultman

NPI #1134997315 in Lincoln Park, Michigan

Provider Information

NPI Number: 1134997315
Entity Type: Individual
Name: Thea Bultman
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Enumeration Date: Dec 18, 2023
Last Updated: Dec 18, 2023

Practice Location

Address: 26184 OUTER DR
City: Lincoln Park
State: Michigan
ZIP Code: 48146-2084
Phone: (313) 389-3942

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X
Social Worker	104100000X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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