Individual
DOMINIQUE JALEH BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
613 HOPE RD, EATONTOWN, NJ 07724-1278
(732) 544-4544
Mailing address
27 MORNINGSIDE AVE, KEANSBURG, NJ 07734-1939
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL07062700
NJ
Other
Enumeration date
10/08/2025
Last updated
10/08/2025
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