Individual
LENA VAUGHN BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
444 2ND LOOP RD, FLORENCE, SC 29505
(843) 536-8674
Mailing address
2580 LIN DO CT, SUMTER, SC 29150-1832
(803) 905-4427
(803) 905-4431
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/13/2016
Last updated
07/18/2018
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