Individual
MS. LISA RENEE BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHRS-CM-CAF
Contact information
Practice address
2725 E SKELLY DR, SUITE 202, TULSA, OK 74105-6241
(918) 382-7300
(918) 494-4924
Mailing address
7509 S TRENTON AVE, TULSA, OK 74136-7306
(918) 814-5676
(918) 494-9424
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CERTIFICATE 9760
OK
Other
Enumeration date
06/11/2007
Last updated
04/29/2009
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