Individual
REBECCA BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 SUNSET DRIVE, CHARLTON, MA 01507
(774) 230-6494
Mailing address
11 SUNSET DRIVE, CHARLTON, MA 01507
(774) 230-6494
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
114699
TX
Other
Enumeration date
03/30/2012
Last updated
09/11/2012
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