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Individual

JAMES HOWARD BULLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
9097 ATLEE STATION RD, SUITE 219, MECHANICSVILLE, VA 23116-2525
(804) 730-2829
(804) 730-2829
Mailing address
9097 ATLEE STATION RD, SUITE 219, MECHANICSVILLE, VA 23116-2525
(804) 730-2829
(804) 730-2829

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001604
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
440242
ANTHEM
VA
05
7705077
VA
Enumeration date
08/01/2006
Last updated
07/08/2007
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