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1114093259
CHARLES SULLIVAN
MEDFORD, MA
NPI
1114093259
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: VT 089.0060196)
Enumeration Date
2006-11-28
Last Update Date
2010-01-04
Business Address
Mr. CHARLES SULLIVAN MSW, LICSW
10 HIGH ST STE 10
MEDFORD, MA 02155-3848
Phone number: 781-395-1560
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Mailing Address
Mr. CHARLES SULLIVAN MSW, LICSW
PO BOX 681
NEWPORT, VT 05855-0681
Phone number: 781-254-4958
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