Individual
MRS. MARTHA BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W., L.C.S.W.
Contact information
Practice address
1045 WILLAGILLESPIE RD, SUITE 200, EUGENE, OR 97401-6721
(541) 343-7171
(541) 284-1765
Mailing address
1045 WILLAGILLESPIE RD, SUITE 200, EUGENE, OR 97401-6721
(541) 343-7171
(541) 284-1765
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L2504
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1261479-9
BIN
OR
Enumeration date
12/29/2006
Last updated
02/22/2010
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