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1376243402
MICHAEL SULLIVAN
BEND, OR
NPI
1376243402
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: OR C6081)
Enumeration Date
2023-03-07
Last Update Date
2023-03-07
Business Address
MICHAEL SULLIVAN
19213 MT SHASTA DR
BEND, OR 97703-3050
Phone number: 802-595-9090
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Mailing Address
MICHAEL SULLIVAN
19213 MT SHASTA DR
BEND, OR 97703-3050
Phone number:
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