Individual
MICHAEL CRAIG BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
950 15TH ST, AUGUSTA, GA 30901-2608
(706) 733-0188
Mailing address
950 15TH ST, AUGUSTA, GA 30901-2608
(706) 733-0188
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
11196
SC
1041C0700X
Clinical Social Worker
Primary
CSW005575
GA
Other
Enumeration date
07/14/2009
Last updated
01/05/2016
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