Individual
ALEXANDRA SOWDEN BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3500 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4395
(215) 590-1000
Mailing address
352 LENAPE LN, CHALFONT, PA 18914-3142
(267) 261-1803
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW020377
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215921457
—
PA
Enumeration date
09/09/2022
Last updated
09/09/2022
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