Bullock, Mary
Bullock, Mary is an individual health care provider with primary practice located at 7437 Cobblestone East Dr , Indianapolis IN 46236-9108. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Bullock, Mary can be contacted via phone (317) 418-7840.Contact Information
Primary practice address
7437 Cobblestone East Dr
Indianapolis IN 46236-9108
Phone: (317) 418-7840
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X |
Profile Details
| NPI number | 1437553989 |
|---|---|
| LBN Legal business name | Bullock, Mary |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2014 |
| Last updated | Oct 13th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437553989 | NPPES |
| Indiana | MEDICAID | 611-1915(I) CMHW | |
| Indiana | MEDICAID | 11 MENTAL HEALTH |
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