NPI 1134215742 · live from the CMS NPI Registry
Rickey Bernard Bullock, Ph.D.
Psychologist, Clinical in Washington, DC. National Provider Identifier 1134215742, active.
NPI record
| NPI | 1134215742 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 50 Irving Street, N.W., Washington, DC 20422 |
| Practice phone | 202-745-8000 |
| Mailing address | 1700 Perrell Lane, Bowie, MD 20716 |
| Enumerated | October 4, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical primary | 103TC0700X | 1666 (DC) |
| Psychologist, Clinical | 103TC0700X | 2884 (MD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.