Bruce Sullivan, LPC

NPI 1508836537 · on the registry since 2006 · sole proprietor

Practice

Address: 450 E Pass Rd
Ste. 3
Gulfport, MS 39507
Phone: (228) 604-0099
Fax: (228) 604-2001
Organisation at this address: Coastal Medical Equipment Llc
Gulfport Precision Vision Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: 101YP2500X
101YP2500X
Licence states on file: MS
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi