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1134842354
MARK ALLEN BULLOCK
CHESTERFIELD, VA
NPI
1134842354
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: VA 0904014366)
Enumeration Date
2022-09-22
Last Update Date
2022-09-22
Business Address
Mr. MARK ALLEN BULLOCK LCSW, CSAC
6801 LUCY CORR CT
CHESTERFIELD, VA 23832-6657
Phone number: 804-748-1227
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Mailing Address
Mr. MARK ALLEN BULLOCK LCSW, CSAC
6801 LUCY CORR BLVD
CHESTERFIELD, VA 23832-6657
Phone number: 804-503-4058
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