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1063181006
SHANNON NICOLE SULLLIVAN
XENIA, OH
NPI
1063181006
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-09-13
Last Update Date
2021-09-13
Business Address
SHANNON NICOLE SULLLIVAN CDCA
515 MARTIN DR
XENIA, OH 45385-1615
Phone number: 937-562-2400
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Mailing Address
SHANNON NICOLE SULLLIVAN CDCA
515 MARTIN DR
XENIA, OH 45385-1615
Phone number: 937-562-2400
Copy
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