| NPI | 1235707472 |
|---|---|
| Other Name | RYAN BULLARD, LCSW |
| Entity Type | Organization |
| Authorized Contact | RYAN BULLARD CEO 850-347-5457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 1041C0700X Social Worker, Clinical | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2023-03-31 |