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Individual

SAUNDRA GAYLE BULLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISAC

Contact information

Practice address
483 WEST SEEDFARM ROAD, HUHUKAM HOSPITAL, SACATON, AZ 85247-0038
(602) 528-7146
(602) 528-1374
Mailing address
483 WEST SEEDFARM ROAD, SACATON, AZ 85247-0038
(602) 528-3321
(602) 528-1374

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-11536
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
LISC-11536
AZ
Enumeration date
02/06/2008
Last updated
02/06/2008
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