Lara Beth Sullivan, CPM

NPI #1477938587 in Kawkawlin, Michigan

Provider Information

NPI Number: 1477938587
Entity Type: Individual
Name: Lara Beth Sullivan, CPM
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Community Health Worker
Credential: CPM
Enumeration Date: Jul 30, 2015
Last Updated: Jul 30, 2015

Practice Location

Address: 2424 WETTERS RD
City: Kawkawlin
State: Michigan
ZIP Code: 48631-9411
Phone: (989) 239-6388

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X	Primary

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