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1205100633
CHRISTA LEA SULLIVAN
PADUCAH, KY
NPI
1205100633
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date
2012-03-02
Last Update Date
2012-03-02
Business Address
-- CHRISTA LEA SULLIVAN
425 BROADWAY ST
PADUCAH, KY 42001-0713
Phone number: 270-442-7121
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Mailing Address
-- CHRISTA LEA SULLIVAN
425 BROADWAY ST
PADUCAH, KY 42001-0713
Phone number:
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