Individual
RENEE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.P.C.
Contact information
Practice address
1401 W 2ND ST UNIT 1, GILLETTE, WY 82716-3334
(307) 682-6699
Mailing address
1311 E OMAHA AVE, FRESNO, CA 93720-2250
(307) 680-0859
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0022007
CO
101YP2500X
Professional Counselor
Primary
1686
WY
101YP2500X
Professional Counselor
MBTCOU-10141
ID
Other
Enumeration date
11/07/2017
Last updated
05/14/2026
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