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Individual

COURTNEY TULLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
322 8TH AVE, NEW YORK, NY 10001-8001
(212) 243-2830
Mailing address
39 HIGH ST APT 311, JERSEY CITY, NJ 07306-2360
(402) 889-0253

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
125177
NY
104100000X
Social Worker
44SL07153500
NJ

Other

Enumeration date
11/11/2024
Last updated
11/11/2024
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