Individual provider · Type 1 NPI

Tiawana Bullock Iii

Counselor · San Rafael, CA

NPI number 1306985502 Active

Practice location

555 Northgate Dr, Family Service Agency Of Marin
San Rafael, CA 94903

Call (415) 491-5700 Map

Fax (415) 491-5750

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1306985502

Tiawana Bullock Iii's National Provider Identifier is 1306985502, issued on Feb 5, 2007. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in San Rafael, CA. The record was last updated on Jul 8, 2007.