Individual
JESSIE E SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2543 ROSS CLARK CIR STE 5, DOTHAN, AL 36301-4916
(334) 699-4007
Mailing address
130 S SPRINGVIEW DR, ENTERPRISE, AL 36330-5060
(151) 752-8055
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/23/2021
Last updated
07/23/2021
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