Individual
GLENDA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10710 S. MORNINGSIDE DR, GOODYEAR, AZ 85338
(623) 932-2429
Mailing address
10710 S. MORNINGSIDE DR, GOODYEAR, AZ 85338
(623) 932-2429
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
2576526
AZ
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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