Individual
MS. DIANNE LYNN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
13380 W TREPANIA RD, HAYWARD, WI 54843-2186
(715) 638-5111
(715) 634-6107
Mailing address
13380 W TREPANIA RD, HAYWARD, WI 54843-2186
(715) 638-5111
(715) 634-6107
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1343-132
WI
Other
Enumeration date
08/01/2013
Last updated
08/01/2013
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