Individual
DESIREE KIMBERLY JANELLE BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2000 NOBLE DR, WOOSTER, OH 44691-5353
(330) 264-3232
Mailing address
434 EASTLAND RD, BEREA, OH 44017-1217
(440) 234-2006
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C.2103266-TRNE
OH
101Y00000X
Counselor
Primary
C.2204687
OH
Other
Enumeration date
09/24/2021
Last updated
10/24/2022
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