Lavalle Deprice Bullard
NPI #1205124039 in Moreno Valley, California
Provider Information
- NPI Number
- 1205124039
- Entity Type
- Individual
- Name
- Lavalle Deprice Bullard
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Case Manager/Care Coordinator
- Enumeration Date
- Jul 13, 2011
- Last Updated
- May 16, 2012
Practice Location
- Address
- 13800 HEACOCK ST
- Address 2
- SUITE C236
- City
- Moreno Valley
- State
- California
- ZIP Code
- 92553-3339
- Phone
- (951) 653-0819
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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