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Individual

MRS. JORDAN BULLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSW

Contact information

Practice address
1308 CRADDUCK RD, ADA, OK 74820-8442
(405) 207-4006
Mailing address
929 N LINDA AVE, ADA, OK 74820-2609
(405) 207-4006

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
07/18/2013
Last updated
07/06/2015
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