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1265104087
ALICIA LYNN SULLIVAN
MOUNT NEBO, WV
NPI
1265104087
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2021-09-30
Last Update Date
2021-09-30
Business Address
ALICIA LYNN SULLIVAN
785 SUMMERSVILLE LAKE RD
MOUNT NEBO, WV 26679-9203
Phone number: 304-883-2334
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Mailing Address
ALICIA LYNN SULLIVAN
PO BOX 569
MOUNT NEBO, WV 26679-0569
Phone number: 304-883-2334
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