Doctor Name: | MR. RANDOLPH JAMES BULPIN |
NPI Number: | 1740506500 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. |
License Number: | 068.0057724 |
Business Practice Address: | 20 Wakefield Street Hardwick, VT - 05843 |
Business Phone Number: | 8024726036 |
Business Fax Number: | |
Mailing Address: | 1326 Dimick Rd, GREENSBORO BEND |
State: | VT |
Postal Code: | 05842 |
Phone Number: | 8025332188 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2010 |
NPI Last Update Date: | 04/19/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 068.0057724 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |