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1447850342
TINA MARIE SULLIVAN
COUNCIL BLUFFS, IA
NPI
1447850342
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IA 101697)
Enumeration Date
2020-10-29
Last Update Date
2022-10-05
Business Address
TINA MARIE SULLIVAN
500 WILLOW AVE STE 305
COUNCIL BLUFFS, IA 51503-0807
Phone number: 712-256-4420
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Mailing Address
TINA MARIE SULLIVAN
1720 N 16TH ST STE K
COUNCIL BLUFFS, IA 51501-0109
Phone number: 712-256-4420
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