Sullivan, Jennifer Jane

Sullivan, Jennifer Jane is an individual health care provider with primary practice located at 123 19Th Street Ne , Watertown SD 57201. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Sullivan, Jennifer Jane can be contacted via phone (605) 886-0123.

Contact Information

Primary practice address
123 19Th Street Ne Watertown SD 57201
Phone: (605) 886-0123
Fax: (605) 886-5447
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X BS DEGREE IN CRIMINA South Dakota

Profile Details

NPI number 1639277205
LBN Legal business name Sullivan, Jennifer Jane
Credentials BS
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639277205 NPPES
South Dakota MEDICAID 5200010

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