Individual
LA'TONYA V SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2307 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-5813
(202) 525-4855
Mailing address
2307 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-5813
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CACII1178
DC
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/01/2023
Last updated
11/01/2023
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