Individual
JENNIFER SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 AMERICAN BLVD E STE 1, BLOOMINGTON, MN 55425-1230
(612) 331-9413
Mailing address
1801 AMERICAN BLVD E STE 1, BLOOMINGTON, MN 55425-1230
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/14/2017
Last updated
08/14/2017
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