Individual
PAMELA JENIECE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3460 WOOLDRIDGE FERRY RD, ELIZABETHTOWN, KY 42701-6131
(270) 697-3011
Mailing address
277 E AMADOR AVE STE 101, LAS CRUCES, NM 88001-3675
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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