| NPI | 1285985812 |
|---|---|
| Former Name | BERENA DYAN SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 129132) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: NY 001240) |
| Enumeration Date | 2012-09-22 |
| Last Update Date | 2025-03-19 |