Individual
STEPHEN CLINTON SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MTBC
Contact information
Practice address
2657 1ST AVE E, NORTH SAINT PAUL, MN 55109-3304
(651) 399-2400
Mailing address
2657 1ST AVE E, NORTH SAINT PAUL, MN 55109-3304
(651) 399-2400
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
—
—
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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