Individual
MISS CRYSTAL LADAWN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, BHRS
Contact information
Practice address
4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5104
(405) 424-7711
Mailing address
717 BILOXI DR APT C, NORMAN, OK 73071-2323
(405) 425-0447
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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