Individual
MRS. JENNIFER O'SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2660 NE HIGHWAY 20 STE 610-437, BEND, OR 97701-6402
(541) 728-3171
Mailing address
3026 NE LARAMIE WAY, BEND, OR 97701-6270
(541) 728-3171
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
L4477
OR
1041C0700X
Clinical Social Worker
Primary
LCSW27793
CA
1041C0700X
Clinical Social Worker
LW60668237
WA
Other
Enumeration date
09/19/2007
Last updated
07/01/2020
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