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Individual
JOHN BULKO
Active
Individual
JOHN BULKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6801097124
MI
1041C0700X
Clinical Social Worker
Primary
6801106731
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801097124
LICENSE #
MI
Enumeration date
04/18/2017
Last updated
04/30/2021
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