Provider Demographics
NPI:1346018157
Name:BULL, JOSELYN ANN
Entity Type:Individual
Prefix:MRS
First Name:JOSELYN
Middle Name:ANN
Last Name:BULL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ANTHONY DR
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-1838
Mailing Address - Country:US
Mailing Address - Phone:802-688-5604
Mailing Address - Fax:
Practice Address - Street 1:395 SHIELDS DR
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-9810
Practice Address - Country:US
Practice Address - Phone:802-688-5604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT147.0123015103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst