WARREN KEITH BULLOCK

BASTROP, LA
NPI1902682016
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: LA  CIT-5695)
Enumeration Date2023-09-05
Last Update Date2023-09-05
Business Address
MR. WARREN KEITH BULLOCK
343 N WASHINGTON ST
BASTROP, LA 71220-3849
Phone number: 318-974-5075
Mailing Address
MR. WARREN KEITH BULLOCK
1103 LAVENDER DR
WINNSBORO, LA 71295-4402
Phone number: 504-274-8007
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