Individual
JANE BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2225 PORTLAND ST, ST JOHNSBURY, VT 05819-8635
(802) 748-3181
Mailing address
PO BOX 724, NEWPORT, VT 05855-0724
(802) 748-3181
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680113354
VT
Other
Enumeration date
07/19/2018
Last updated
06/23/2025
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