Individual
JENNIFER LYNN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1709 MOON ST NE, ALBUQUERQUE, NM 87112-3935
(505) 271-0329
Mailing address
1709 MOON ST NE, ALBUQUERQUE, NM 87112-3935
(505) 271-0329
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-10706
NM
Other
Enumeration date
08/19/2016
Last updated
12/01/2025
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