Individual
TALYA BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3315 GOOSE CREEK RD, LOUISVILLE, KY 40241-2541
(502) 426-2164
Mailing address
3315 GOOSE CREEK RD, LOUISVILLE, KY 40241-2541
(502) 426-2164
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1889
KY
Other
Enumeration date
09/26/2014
Last updated
09/26/2014
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