Individual
JOHN MICHAEL SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
ONE OLD OYSTER POINT ROAD, NEWPORT NEWS, VA 23602
(757) 969-6848
Mailing address
10145 SQUIRES WAY, TOANO, VA 23168-9541
(757) 566-2238
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810004303
VA
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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