Individual
JILLIAN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
504 LAKESIDE DRIVE, SOUTHAMPTON, PA 18966
(215) 354-0777
Mailing address
504 LAKESIDE DRIVE, SOUTHAMPTON, PA 18966
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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