Individual
MR. SULLAVAN O'HARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3 HOSPITAL DR, COLUMBIA, MO 65201-5276
(573) 884-1255
(573) 884-1010
Mailing address
816 S CENTRAL ST, CENTRALIA, MO 65240-1810
(816) 786-0609
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/17/2020
Last updated
05/17/2020
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