Individual
RITA BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1626 PUTNEY RD, VALLEY STREAM, NY 11580-1818
(718) 618-5075
Mailing address
17015 LITHONIA AVE APT 1, FRESH MEADOWS, NY 11365-1105
(917) 232-6870
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
NY
Other
Enumeration date
02/25/2019
Last updated
02/25/2019
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