Individual
JESSICA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4545 DODGE ST, OMAHA, NE 68132-3232
(402) 553-6000
Mailing address
4545 DODGE ST, OMAHA, NE 68132-3232
(402) 553-6000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6015
NE
101YP2500X
Professional Counselor
11863
NE
Other
Enumeration date
08/09/2019
Last updated
03/01/2024
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