Individual
ELIZABETH BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
255 BANK ST, WATERBURY, CT 06702-2219
(860) 414-2922
(203) 759-0566
Mailing address
29 ALBION ST, WATERBURY, CT 06705-1946
(203) 528-8909
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
4383
CT
101YP2500X
Professional Counselor
Primary
5123
CT
Other
Enumeration date
12/31/2020
Last updated
11/23/2021
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