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Organization
TRISH SULLIVANT
Active
Organization
TRISH SULLIVANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA SULLIVANT LCSW (OWNER)
(801) 541-9566
Entity
Organization
Contact information
Practice address
4505 S WASATCH BLVD STE 360, SALT LAKE CITY, UT 84124-4203
(801) 541-9566
Mailing address
8676 S 1700 E, SANDY, UT 84093-1425
(801) 541-9566
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
86376063501
UT
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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