Individual
KEVIN ANTONIO BULLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
851 JANE ST, LUMBERTON, NC 28358-5044
(910) 258-1417
Mailing address
851 JANE ST, LUMBERTON, NC 28358-5044
(910) 258-1417
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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