Individual
CORINNE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8686 S 1300 E, SANDY, UT 84094-1947
(801) 709-0748
(801) 609-9852
Mailing address
8686 S 1300 E, SANDY, UT 84094-1947
(801) 709-0748
(801) 609-9852
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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