Individual
LISA M SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
379 RAVEN CIR, VALPARAISO, IN 46385-8135
(219) 781-1068
Mailing address
379 RAVEN CIR, VALPARAISO, IN 46385-8135
(219) 781-1068
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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