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Individual

KRISTINE DANA BULLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
1012 HARRISON AVE, LEADVILLE, CO 80461-3323
(303) 601-5620
Mailing address
12889 S SILVER PLUME ST, PARKER, CO 80134-7485
(303) 601-5620

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP.0001897
CO

Other

Enumeration date
08/19/2013
Last updated
11/17/2017
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