Individual
SHAREL SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12248 CHINA LAKE DR, DALLAS, TX 75253-3045
(972) 670-0559
Mailing address
12248 CHINA LAKE DR, DALLAS, TX 75253-3045
(972) 670-0559
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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