Individual
MS. AMANDA S SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHCA
Contact information
Practice address
2852 WESLEYAN LN, WINSTON SALEM, NC 27106-5848
(336) 926-0702
Mailing address
2852 WESLEYAN LN, WINSTON SALEM, NC 27106-5848
(336) 926-0702
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A15051
NC
Other
Enumeration date
03/18/2021
Last updated
03/18/2021
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