Individual
JARED MARK BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
25 WAREHAM ST BLDG 4, MIDDLEBORO, MA 02346-2456
(508) 465-0417
Mailing address
25 WAREHAM ST BLDG 4, MIDDLEBORO, MA 02346-2456
(508) 465-0417
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
MA
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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