Amy Bullock, LCSW
Social Worker, Clinical in El Centro, CA. Individual provider (NPI-1).
NPI number1871997692
StatusActive
Last updated in NPPESOct 22, 2014
Details
- NPI
- 1871997692
- Entity type
- Individual (NPI-1)
- Name
- Amy Bullock
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 22, 2014
- Last updated
- Oct 22, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 61927 | CA | Yes |
Practice location
1073 Ross Ave Ste CEl Centro, CA 92243-4371
Phone 760-540-4335 · Fax 760-482-5696
Mailing address
52 W Pheasant StHeber, CA 92249-9658
Phone 760-540-4335 · Fax 760-482-5696
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