Bullard, Latoya

Bullard, Latoya is an sole proprietor health care provider with primary practice located at 4736 34Th Ave , Vero Beach FL 32967-1234. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Bullard, Latoya can be contacted via phone (772) 713-4130.

Contact Information

Primary practice address
4736 34Th Ave Vero Beach FL 32967-1234
Phone: (772) 713-4130
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X Florida

Profile Details

NPI number 1598250193
LBN Legal business name Bullard, Latoya
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 26th, 2018
Last updated Jul 11th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598250193 NPPES
Florida Other 46-5201707 FLORIDA BLUE
Florida MEDICAID 1598250193 FLORIDA BLUE

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