Individual
LISA O'SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
612 9TH ST, ROYAL OAK, MI 48067-3144
(586) 212-1744
Mailing address
612 9TH ST, ROYAL OAK, MI 48067-3144
(586) 212-1744
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/24/2024
Last updated
08/24/2024
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