person
Dominique Bullocks
Mental Health Counselor in Jackson, Mississippi
NPI 1568105575

Dominique Bullocks is a Mental Health Counselor based in Jackson, MS and is specialized in Mental Health. Dominique Bullocks practices in Jackson, MS. The NPI Number for Dominique Bullocks is 1568105575 and holds a License No. (Mississippi).

The current practice location address for Dominique Bullocks is 4780 I 55 N Ste 105, Jackson, MS and can be reached out via phone at 601-956-4816 and via fax at 601-956-4817.

Location: 4780 I 55 N Ste 105, Jackson, MS, 39211-5542
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Provider Profile Details
NPI Number
1568105575
Provider Name
Dominique Bullocks
Credential
Provider Entity Type
Individual
Gender
Female
Address
4780 I 55 N Ste 105, Jackson, MS, 39211-5542
Phone Number
601-956-4816
Fax Number
601-956-4817
Provider Enumeration Date
04/18/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01670076 05 MS
institution
Provider Business Practice Location Address Details
Address
4780 I 55 N Ste 105
City
State
Zip
39211-5542
Phone Number
601-956-4816
Fax Number
601-956-4817
person
Provider Business Mailing Address Details
Address
4780 I 55 N Ste 105
City
State
Zip
39211-5542
Phone Number
601-956-4816
Fax Number
601-956-4817
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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