Individual
MRS. JESSICA MICHELLE BULTHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178.008309
IL
101YP2500X
Professional Counselor
Primary
180009706
IL
Other
Enumeration date
09/07/2012
Last updated
05/18/2015
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