Individual
JOHN M SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1104 CAVALIER DR, WAUKESHA, WI 53186-6883
(262) 993-9231
Mailing address
1104 CAVALIER DR, WAUKESHA, WI 53186-6883
(262) 993-9231
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7803-125
WI
Other
Enumeration date
07/31/2020
Last updated
03/01/2022
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