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Individual
MICHAEL BULLOCK
Active
Individual
MICHAEL BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW-S
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.0008730
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I.0008730
LISW-S
OH
Enumeration date
11/19/2015
Last updated
11/19/2015
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