Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CHARLA RENEE BULLARD, ATR-BC, LPAT
Active Sole ProprietorArt Therapist · JACKSON, MS
Registration Details
- NPI Number
- 1942827365
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 1, 2020 (5.8082909092678 yrs)
- Last Updated
- Jul 1, 2020
- License
-
PAT0008 (MS)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1500 E WOODROW WILSON AVE # 117JACKSON, MS, 392165116Browse MS providers · Browse ZIP 39216
- Phone
- 6013624471
- Primary Specialty
-
Art Therapist
221700000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.