Individual
CHRYSTIN BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
203 E 10TH ST, SANFORD, FL 32771-2621
(407) 460-1021
(407) 386-7033
Mailing address
203 E 10TH ST, SANFORD, FL 32771-2621
(407) 460-1021
(407) 386-7033
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
BCBA 1052521
FL
Other
Enumeration date
05/04/2008
Last updated
05/04/2008
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