| NPI | 1104200781 |
|---|---|
| Former Name | MARIAN SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 64461) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 115615) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2016-08-25 |