Individual
JERMAINE NICHOLAS SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NCC
Contact information
Practice address
365 NORTHRIDGE RD STE 310, ATLANTA, GA 30350-6101
(770) 771-6900
Mailing address
2788 DEFOORS FERRY RD NW APT 333, ATLANTA, GA 30318-2139
(404) 401-6068
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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