Individual
JESSICA TULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 N 47TH ST, KANSAS CITY, KS 66102-1705
(913) 689-2199
Mailing address
1301 N 47TH ST, KANSAS CITY, KS 66102-1705
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2842
KS
Other
Enumeration date
06/14/2018
Last updated
06/14/2018
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