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Individual

JAYME SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1414 CHERRY ST, VICKSBURG, MS 39180-3218
(601) 636-5703
(769) 230-3039
Mailing address
1414 CHERRY ST, VICKSBURG, MS 39180-3218
(601) 636-5703

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
108
MS

Other

Enumeration date
03/11/2021
Last updated
03/11/2021
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