Individual
JEFFERSON LEE BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(267) 738-6526
(215) 563-0748
Mailing address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(267) 738-6526
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW019448
PA
Other
Enumeration date
08/15/2017
Last updated
03/04/2026
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