Provider Demographics
NPI:1013995075
Name:BULL, REX WARREN (PHD)
Entity Type:Individual
Prefix:DR
First Name:REX
Middle Name:WARREN
Last Name:BULL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W WINTHROPE RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-2432
Mailing Address - Country:US
Mailing Address - Phone:816-523-8014
Mailing Address - Fax:
Practice Address - Street 1:520 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64124-1514
Practice Address - Country:US
Practice Address - Phone:816-404-6346
Practice Address - Fax:816-404-6347
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR0321103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical