Individual provider · Type 1 NPI
Mark Dana Bullock, PhD
Mental Health Counselor · Hayden, ID
NPI number
1346370277
Active
Practice location
6160 E Hayden Lake Rd
Hayden, ID 83835-7594
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | LPC-988 (ID) |
Mental Health Counselor: Definition to come...
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About NPI 1346370277
Mark Dana Bullock, PhD's National Provider Identifier is 1346370277, issued on Mar 7, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Hayden, ID. The record was last updated on Jul 8, 2007.