Individual
AMY BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1073 ROSS AVE STE C, EL CENTRO, CA 92243-4371
(760) 540-4335
(760) 482-5696
Mailing address
52 W PHEASANT ST, HEBER, CA 92249-9658
(760) 540-4335
(760) 482-5696
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
61927
CA
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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