Individual
BRIDGETTE RACHELLE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 E MONROE AVE, MCALESTER, OK 74501-4815
(918) 426-7800
Mailing address
418 S MAIN ST # 287, EUFAULA, OK 74432-3252
(918) 916-1727
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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