Provider Demographics
NPI:1710742051
Name:BULLOCK, MARIANNE ELIZABETH (DOULA)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:ELIZABETH
Last Name:BULLOCK
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-3519
Mailing Address - Country:US
Mailing Address - Phone:413-835-5553
Mailing Address - Fax:
Practice Address - Street 1:179 HOPE ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3519
Practice Address - Country:US
Practice Address - Phone:413-835-5553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula