Individual
MISS BERTHA DELOIS BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
2472 TONOLOWAY DR, RALEIGH, NC 27610-7190
(252) 739-6641
(252) 739-6641
Mailing address
2472 TONOLOWAY DR, RALEIGH, NC 27610-7190
(919) 790-7775
(919) 790-9755
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P023264
NC
Other
Enumeration date
03/09/2026
Last updated
03/09/2026
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