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Individual

JACK PULLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
111 S CORTEZ ST, PRESCOTT, AZ 86303-4703
(928) 756-9083
Mailing address
111 S CORTEZ ST, PRESCOTT, AZ 86303-4703
(928) 756-9083

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC-16329
AZ
101YM0800X
Mental Health Counselor
Primary
LPC-16329
AZ

Other

Enumeration date
03/07/2018
Last updated
12/16/2021
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