Individual
DR. CHESTER WAYNE BULLOCK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD, MED
Contact information
Practice address
910 17TH ST NW STE 419, WASHINGTON, DC 20006-2605
(202) 505-2795
Mailing address
910 17TH ST NW STE 419, WASHINGTON, DC 20006-2605
(202) 505-2795
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
06/22/2009
Last updated
06/10/2022
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