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1215402300
DEIDRA BULLOCK
GREENWOOD, MS
NPI
1215402300
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-10-04
Last Update Date
2018-10-04
Business Address
DEIDRA BULLOCK
2504 BROWNING ROAD 520
GREENWOOD, MS 38930-6022
Phone number: 662-453-6211
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Mailing Address
DEIDRA BULLOCK
2504 BROWNING ROAD 520
GREENWOOD, MS 38930-6022
Phone number: 662-453-6211
Copy
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