Individual
TIARA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
2706 N CHURCH ST, GREENSBORO, NC 27405-3657
(336) 272-9990
(336) 574-8378
Mailing address
2706 N CHURCH ST, GREENSBORO, NC 27405-3657
(336) 272-9990
(336) 574-8378
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-22410
NC
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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