Individual
ANN BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5535 S WILLIAMSON BLVD, 774, PORT ORANGE, FL 32128-8311
(800) 330-7711
(386) 944-7202
Mailing address
5535 S WILLIAMSON BLVD, 774, PORT ORANGE, FL 32128-8311
(800) 330-7711
(386) 944-7202
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10199
NC
Other
Enumeration date
06/18/2013
Last updated
06/18/2013
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