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NPI Code Detail

MEDICARE: BRITTANY BULLEN

MEDICARE:   BRITTANY  BULLEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor14126887-6009UT

General Provider Information

NPI Number : 1811720873
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY BULLEN
Provider Business Mailing Address
First Line : 2055 E 3900 S STE 200
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-1766
Country : US
Telephone Number : 801-251-6519
Fax Number :
Provider Business Practice Location Address
First Line : 2055 E 3900 S STE 200
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-1766
Country : US
Telephone Number : 801-251-6519
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2024
Last Update Date : 08/23/2024

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Directions to “ BRITTANY BULLEN ” Practice Location

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