Individual
ALICIA N SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
522 W PARK AVE STE Q-R, GREENWOOD, MS 38930-2906
(662) 374-5029
Mailing address
860 E RIVER PL STE 100, JACKSON, MS 39202-3442
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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