Individual
JAMIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 S GILBERT RD, GILBERT, AZ 85296-4019
(480) 621-8361
Mailing address
1305 S GILBERT RD, GILBERT, AZ 85296-4019
(480) 621-8361
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6554
AZ
Other
Enumeration date
07/09/2016
Last updated
07/09/2016
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