Individual
JOANNA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 ROGERS DR, HOLDENVILLE, OK 74848
(405) 379-6668
(405) 379-5372
Mailing address
223 W 8TH ST, HOLDENVILLE, OK 74848-3432
(405) 712-9172
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/26/2023
Last updated
02/23/2023
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