Sullivan, Teri Rae

Sullivan, Teri Rae is an individual health care provider with primary practice located at 7180 W 107Th St Suite 20, Overland Park KS 66212-2523. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Sullivan, Teri Rae can be contacted via phone (913) 341-5700.

Contact Information

Primary practice address
7180 W 107Th St Suite 20 Overland Park KS 66212-2523
Phone: (913) 341-5700
Fax: (913) 341-5750
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X KS0442 Kansas

Profile Details

NPI number 1023050168
LBN Legal business name Sullivan, Teri Rae
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jan 17th, 2008 - about 16 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 1023050168 NPPES
Kansas MEDICAID SUS71097

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