| NPI | 1053425751 |
|---|---|
| Former Name | JAMIE LEE SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 1673) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN cc00333) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2023-10-12 |