| Jennifer E Bullard Ma, Lpc, Pc | |
|
1751 Broad Park Cir S Suite 207 Mansfield TX 76063-7826 | |
| (817) 291-4564 | |
| (817) 473-7787 |
| Full Name | Jennifer E Bullard Ma, Lpc, Pc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1751 Broad Park Cir S, Mansfield, Texas |
| Authorized Official Name and Position | Jennifer E Bullard (PRESIDENT) |
| Authorized Official Contact | 8172914564 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer E Bullard Ma, Lpc, Pc 5554 Amistad St Fort Worth TX 76137-5365 Ph: (817) 291-4564 | Jennifer E Bullard Ma, Lpc, Pc 1751 Broad Park Cir S Suite 207 Mansfield TX 76063-7826 Ph: (817) 291-4564 |
| NPI Number | 1497064745 |
|---|---|
| Provider Enumeration Date | 10/05/2010 |
| Last Update Date | 10/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497064745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 17244 (Texas) | Primary |
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