Provider Demographics
NPI:1558713982
Name:BULLARD, CHYKIMBERLY QUANTEZ (EDS, MS)
Entity Type:Individual
Prefix:MS
First Name:CHYKIMBERLY
Middle Name:QUANTEZ
Last Name:BULLARD
Suffix:
Gender:F
Credentials:EDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8350 NW 52ND TER STE 301
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7708
Mailing Address - Country:US
Mailing Address - Phone:844-744-0746
Mailing Address - Fax:844-300-7683
Practice Address - Street 1:1400 NE 125TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-6034
Practice Address - Country:US
Practice Address - Phone:305-883-5188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health