Individual
MIKELL DESMOND BULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, ST
Contact information
Practice address
44 BRAVES AVE APT 2438, LAWRENCEVILLE, GA 30043-3374
(770) 696-8617
Mailing address
44 BRAVES AVE APT 2438, LAWRENCEVILLE, GA 30043-3374
(770) 696-8617
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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