BLAKE A BULLOCK

URBANA, IL
NPI1295505014
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149.024395)
Enumeration Date2024-01-03
Last Update Date2024-01-03
Business Address
BLAKE A BULLOCK LCSW
206 SPRING CIR
URBANA, IL 61802-7566
Phone number: 309-540-8401
Mailing Address
BLAKE A BULLOCK LCSW
206 SPRING CIR
URBANA, IL 61802-7566
Phone number: 309-540-8401
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