# TRISHA MAE BULLARD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114333093
- **Gender:** F
- **Credential:** PA-C, PTA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225200000X | Physical Therapy Assistant | 1054 | NH | — |
| 363AS0400X | Surgical Physician Assistant | 055.0031399 | VT | Yes |

## Other

- **Enumeration date:** 07/11/2014
- **Last updated:** 11/09/2018