Individual
MRS. PATRICIA TAMMETTE BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
622 RIVERSIDE DR, MONROE, LA 71201-6211
(318) 398-0945
Mailing address
56 RATTLESNAKE RD, MANGHAM, LA 71259-5332
(318) 537-6220
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6359
LA
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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