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Individual

LAUREN BULLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CF-SLP

Contact information

Practice address
3601 S CHICAGO AVE, SOUTH MILWAUKEE, WI 53172-3708
(414) 570-5477
Mailing address
3601 S CHICAGO AVE, SOUTH MILWAUKEE, WI 53172-3708
(414) 570-5477

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5027-154
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
34-1892096
WI
Enumeration date
06/02/2020
Last updated
06/02/2020
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