Individual
MS. GINA MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II
Contact information
Practice address
245 N MURRAY ST, BANNING, CA 92220-5528
(951) 849-8812
(951) 755-8915
Mailing address
245 N MURRAY ST, BANNING, CA 92220-5528
(951) 849-8812
(951) 755-8915
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
829898
CA
Other
Enumeration date
12/03/2010
Last updated
12/03/2010
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