Individual
MR. MATT KEVIN BULLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C. NCC
Contact information
Practice address
2460 W HIGHWAY 56, #5, CEDAR CITY, UT 84720-4118
(435) 327-2137
Mailing address
1009 IRONWOOD CIR, CEDAR CITY, UT 84721-5125
(435) 327-2137
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2785863-6004
UT
101YP2500X
Professional Counselor
Primary
2785863-6004
UT
Other
Enumeration date
04/23/2008
Last updated
11/11/2009
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