Individual
MRS. CARLY BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3101 FINE AVE, MODESTO, CA 95355-9702
(209) 552-3200
Mailing address
3101 FINE AVE, MODESTO, CA 95355-9702
(209) 552-3200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12632
CA
Other
Enumeration date
02/18/2026
Last updated
02/18/2026
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