| Madeline Bullock, | |
|
2802 145th St W, Rosemount, MN 55068-4940 | |
| (651) 387-0616 | |
| Not Available |
| Full Name | Madeline Bullock |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 2802 145th St W, Rosemount, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427827310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (Minnesota) | Primary |
| Entity Name | Life Development Resources Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902953169 PECOS PAC ID: 5890779847 Enrollment ID: O20040616000985 |
| Mailing Address | Practice Location Address |
|---|---|
| Madeline Bullock, 2802 145th St W, Rosemount, MN 55068-4940 Ph: (651) 387-0616 | Madeline Bullock, 2802 145th St W, Rosemount, MN 55068-4940 Ph: (651) 387-0616 |
Kimberly Swanson, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 14325 Cormorant Way, Rosemount, MN 55068 Phone: 612-532-8455 | |
Mr. Brian Paul Ario, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 12802 S Robert Trl, Rosemount, MN 55068 Phone: 952-388-4110 | |
Jennifer Ario, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 12802 S Robert Trl, Rosemount, MN 55068 Phone: 952-388-4850 | |
Kelly J Kivel, LPCC, LPC Counselor Medicare: Medicare Enrolled Practice Location: 15265 Carrousel Way, Rosemount, MN 55068 Phone: 952-443-4600 | |
Richard Carroll Burleson, Counselor Medicare: Medicare Enrolled Practice Location: 15265 Carrousel Way, Rosemount, MN 55068 Phone: 952-433-4600 Fax: 651-322-4603 | |
Mrs. Christina Anne Preston, MA, LADC Counselor Medicare: Medicare Enrolled Practice Location: 15265 Carrousel Way, Rosemount, MN 55068 Phone: 952-443-4600 Fax: 952-443-4604 | |
Alyssa Rose Kittleson, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 15265 Carrousel Way, Rosemount, MN 55068 Phone: 952-443-4600 |