Individual
HEATHER KASSI SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 W WASHBOURNE ST, JAY, OK 74346-4205
(918) 308-5513
Mailing address
1015 W WASHBOURNE ST, JAY, OK 74346-4205
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/29/2021
Last updated
06/27/2023
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