Individual
MRS. RENEE L SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
153 MARCAR RD, MACON, GA 31216-5929
(478) 718-1306
Mailing address
153 MARCAR RD, MACON, GA 31216-5929
(478) 718-1306
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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