Individual provider · Type 1 NPI
Mary Jo Sullivan, LADC
Addiction (Substance Use Disorder) Counselor · Norman, OK
NPI number
1407078983
Active
Practice location
125 Pine Tree Ln
Norman, OK 73072-5012
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 174 (OK) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1407078983
Mary Jo Sullivan, LADC's National Provider Identifier is 1407078983, issued on May 3, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Norman, OK. The record was last updated on Apr 22, 2020.