Mariah Bullock, PHD

Individual provider Active NPI Psychologist · Cottonwood Heights, UT

NPI 1144075409 · NPPES record last updated Apr 20, 2024

Key facts

NPI
1144075409
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
Practice address
7080 S 2985 E
Cottonwood Heights, UT 84121-4254
Phone
(714) 222-0002
NPI assigned
Apr 20, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Yes

Addresses

Primary practice location

7080 S 2985 E
Cottonwood Heights, UT 84121-4254

Mailing address

7080 S 2985 E
Cottonwood Heights, UT 84121-4254
Phone (714) 222-0002

Other names

  • Mariah Nogueira Former name

Other providers in Cottonwood Heights, UT

All providers in Cottonwood Heights, UT · Psychologist in Utah

Sources for this page

Verify at the official NPI Registry.