Individual
ASHLEY BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4977 NORTHCUTT PL, DAYTON, OH 45414-3839
(937) 387-6395
Mailing address
509 XENIA AVE, DAYTON, OH 45410-1823
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.179536
OH
Other
Enumeration date
03/04/2022
Last updated
03/04/2022
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