Individual
TENECIA BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3334 WISCONSIN AVENUE, WARREN-YAZOO MENTAL HEALTH SERVICES, VICKSBURG, MS 39180-2067
(601) 638-0031
Mailing address
3334 WISCONSIN AVENUE, WARREN-YAZOO MENTAL HEALTH SERVICES, VICKSBURG, MS 39180-2067
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/24/2011
Last updated
03/24/2011
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