Individual
DR. JOHN PATRICK SULLIVAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
8 BRADFORD AVE, NEWPORT, RI 02840-2202
(401) 258-6754
Mailing address
8 BRADFORD AVE, NEWPORT, RI 02840-2202
(401) 258-6754
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS00871
RI
103TE1100X
Exercise & Sports Psychologist
PS00871
RI
Other
Enumeration date
12/29/2009
Last updated
12/29/2009
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