Individual
DAIJA BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
256 WASHINGTON ST STE 4, MOUNT VERNON, NY 10553-1056
(914) 613-0700
Mailing address
8 RAMBLEWOOD DR, NEWBURGH, NY 12550-7709
(845) 527-5929
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
109054
NY
Other
Enumeration date
12/26/2022
Last updated
12/26/2022
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