Individual
IRENE ERVIN BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1600 WESTBROOK AVE STE 134, RICHMOND, VA 23227-3326
(804) 292-3500
(888) 382-0230
Mailing address
7331 RIVENDELL TER, NORTH CHESTERFIELD, VA 23234-5970
(804) 497-9518
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904014900
VA
Other
Enumeration date
07/07/2023
Last updated
03/27/2024
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