Individual provider · Type 1 NPI
Gizelle Marie Bullock, LMHC
Mental Health Counselor · Heuvelton, NY
NPI number
1710245758
Active
Practice location
76 Lisbon St
Heuvelton, NY 13654-3130
Fax (315) 254-2811
Other practice locations
- 1003 Park St, Ogdensburg, NY 13669-3911 · (315) 713-9090
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 004799 (NY) |
Mental Health Counselor: Definition to come...
About NPI 1710245758
Gizelle Marie Bullock, LMHC's National Provider Identifier is 1710245758, issued on Apr 27, 2012. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Heuvelton, NY. The record was last updated on Sep 22, 2023.