NPI 1942827365

Charla Renee Bullard, ATRBCLPAT

Practitioner Art Therapist Jackson, MS

Practice location

Address: 1500 E Woodrow Wilson Ave # 117, Jackson, MS 39216-5116
Phone: (601) 362-4471

Registered specialties

Art Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 221700000X Licence PAT0008 (MS)

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Registry record

NPI: 1942827365
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 Jul 2020
Record last updated: 1 Jul 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.