| NPI | 1730947599 |
|---|---|
| Other Name | TEDDY SULLIVAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39005758A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 101056) |
| 101YM0800X Counselor, Mental Health (Licence: IL 180.018283) | |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2026-08-04 |