| NPI | 1144078395 |
|---|---|
| Former Name | DANIELLE SULLIVAN |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW21151) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149025928) |
| Enumeration Date | 2024-05-10 |
| Last Update Date | 2024-05-10 |