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Individual
MR. DYLAN SULLIVAN
Active
Individual
MR. DYLAN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COUNSELOR TRNE
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C.2203820-TRNE
OH
101YM0800X
Mental Health Counselor
C2203820-TRNE
OH
175T00000X
Peer Specialist
0002025
OH
Other
Enumeration date
09/23/2020
Last updated
01/25/2022
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