Individual
SALLY SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1202 OFFICE PARK DR., SUITE A, OXFORD, MS 38655
(662) 801-6940
(662) 234-3535
Mailing address
1202 OFFICE PARK DR., SUITE A, OXFORD, MS 38655
(662) 801-6940
(662) 234-3535
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1969
MS
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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