Individual
JENNIFER SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2345 E 2ND ST, CASPER, WY 82609-2048
(307) 233-2200
Mailing address
2345 E 2ND ST, CASPER, WY 82609-2048
(307) 233-2000
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCSW-1042
WY
101YP2500X
Professional Counselor
PCSW-560
WY
Other
Enumeration date
10/17/2014
Last updated
07/21/2022
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