Individual
MARY BULLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
21895 CRESCENT PARK SQ, APT 303, BROADLANDS, VA 20148-4434
(724) 433-9242
Mailing address
21895 CRESCENT PARK SQ, APT 303, BROADLANDS, VA 20148-4434
(724) 433-9242
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005384
VA
Other
Enumeration date
02/12/2011
Last updated
02/12/2011
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