Lisa Sullivan

NPI #1285282459 in Boise, Idaho

Provider Information

NPI Number: 1285282459
Entity Type: Individual
Name: Lisa Sullivan
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Aug 29, 2019
Last Updated: Aug 29, 2019

Practice Location

Address: 719 N HILLVIEW DR
City: Boise
State: Idaho
ZIP Code: 83712-8122
Phone: (208) 859-8703

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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