Individual
KRYSTLE LYNN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
66 ANNA MARIA LN, WINDHAM, CT 06280-1350
(860) 368-9964
Mailing address
66 ANNA MARIA LN, WINDHAM, CT 06280-1350
(860) 368-9964
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003137
CT
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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