Jasmine La'tese Bullock, LMSW

NPI #1528523842 in Lincoln Park, Michigan

Provider Information

NPI Number: 1528523842
Entity Type: Individual
Name: Jasmine La'tese Bullock, LMSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Credential: LMSW
Enumeration Date: Feb 1, 2019
Last Updated: Aug 7, 2023

Practice Location

Address: 26300 OUTER DR
City: Lincoln Park
State: Michigan
ZIP Code: 48146-2019
Phone: (313) 388-4630

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary
Social Worker - Clinical — Clinical	1041C0700X

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