Provider Demographics
NPI:1588347371
Name:HJB THERAPY, LLC
Entity type:Organization
Organization Name:HJB THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:J
Authorized Official - Last Name:NERESON-BOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-378-6201
Mailing Address - Street 1:2601 HAGUE AVE SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-2335
Mailing Address - Country:US
Mailing Address - Phone:616-826-9662
Mailing Address - Fax:
Practice Address - Street 1:3181 PRAIRIE ST SW
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-2097
Practice Address - Country:US
Practice Address - Phone:616-378-6201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty