Individual
JEANETTE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATR-BC
Contact information
Practice address
70 SILVERADO DR, BASALT, CO 81621-9232
(352) 514-1625
Mailing address
70 SILVERADO DR, BASALT, CO 81621-9232
(352) 514-1625
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
—
—
Other
Enumeration date
02/04/2022
Last updated
02/04/2022
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