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Individual

PAMELA BULLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1121 SUMNER RD SE, WASHINGTON, DC 20020-5837
(202) 910-0432
Mailing address
1121 SUMNER RD SE, WASHINGTON, DC 20020-5837

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7041319
DC
Enumeration date
08/11/2017
Last updated
08/11/2017
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