person
Dr. Mark Dana Bullock, PHD
Mental Health Counselor in Hayden, Idaho
NPI 1346370277

Mark Dana Bullock is a Mental Health Counselor based in Hayden, ID and is specialized in Mental Health. Mark Dana Bullock practices in Hayden, ID and has the professional credentials of PHD. The NPI Number for Mark Dana Bullock is 1346370277 and holds a License No. LPC-988 (Idaho).

The current practice location address for Mark Dana Bullock is 6160 E Hayden Lake Rd, Hayden, ID and can be reached out via phone at 208-699-8044.

Location: 6160 E Hayden Lake Rd, Hayden, ID, 83835-7594
person
Provider Profile Details
NPI Number
1346370277
Provider Name
Mark Dana Bullock
Credential
PHD
Provider Entity Type
Individual
Gender
Male
Address
6160 E Hayden Lake Rd, Hayden, ID, 83835-7594
Phone Number
208-699-8044
Fax Number
Provider Enumeration Date
03/07/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
6160 E Hayden Lake Rd
City
State
Zip
83835-7594
Phone Number
208-699-8044
Fax Number
person
Provider Business Mailing Address Details
Address
6160 E Hayden Lake Rd
City
State
Zip
83835-7594
Phone Number
208-699-8044
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LPC-988 (Idaho)
Definition
Definition to come...
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