Individual
EVELYN R SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2653 SW 87TH DR, SUITE A, GAINESVILLE, FL 32608-9313
(352) 331-0020
(352) 331-0022
Mailing address
2653 SW 87TH DR, SUITE A, GAINESVILLE, FL 32608-9313
(352) 331-0020
(352) 331-0022
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY0005750
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54357
BCBS FL
—
Enumeration date
09/08/2006
Last updated
11/08/2010
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