Individual
CANDICE BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, LCSW
Contact information
Practice address
107 S 5TH ST, RICHMOND, VA 23219-3825
(804) 637-2569
Mailing address
107 S 5TH ST, RICHMOND, VA 23219-3825
(804) 637-2569
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904015833
VA
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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