Individual
JAYLA SNIPES BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
618 BOWENS MILL ROAD SW, DOUGLAS, GA 31533
(912) 389-0077
(912) 389-0997
Mailing address
P O BOX 3306, DOUGLAS, GA 31534-3306
(912) 389-0077
(912) 389-0997
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005166
GA
Other
Enumeration date
01/22/2009
Last updated
10/15/2010
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