Individual
ALEXANDRIA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
122 N NEW BETHEL BLVD, ADA, OK 74820-0307
(580) 495-9226
Mailing address
122 N NEW BETHEL BLVD, ADA, OK 74820-0307
(580) 495-9226
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
E083215478
OK
Other
Enumeration date
07/15/2026
Last updated
07/15/2026
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