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Individual

JESSICA SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4813 BRISTOL BAY WAY APT 302, TAMPA, FL 33619-3662
(813) 562-8475
Mailing address
4813 BRISTOL BAY WAY APT 302, TAMPA, FL 33619-3662
(813) 562-8475

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
FL

Other

Enumeration date
07/28/2022
Last updated
07/28/2022
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