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Individual

DR. RICKEY BERNARD BULLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
50 IRVING STREET, N.W., WASHINGTON, DC 20422
(202) 745-8000
(202) 518-4697
Mailing address
1700 PERRELL LANE, BOWIE, MD 20716-1655
(301) 249-4960
(301) 249-0568

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1666
DC
103TC0700X
Clinical Psychologist
2884
MD

Other

Enumeration date
10/04/2006
Last updated
07/08/2007
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