Individual
MS. MICHELLE STARR BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4217 NW 22ND ST, OKLAHOMA CITY, OK 73107
(405) 431-9744
Mailing address
4217 NW 22ND ST., OKLAHOMA CITY, OK 73107
(405) 431-9744
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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