Individual
ANTHONY DE'VONNE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 755-8745
Mailing address
8716 W UNIVERSITY ST APT C, WICHITA, KS 67209-1650
(316) 250-7823
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9386
KS
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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