Individual
DR. LISA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD.
Contact information
Practice address
18625 MACALPINE LOOP, BEND, OR 97702-9366
(760) 672-1787
Mailing address
18625 MACALPINE LOOP, BEND, OR 97702-9366
(760) 672-1787
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
17800
CA
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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