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1457645434
KELLY SULLIVAN
MILWAUKIE, OR
NPI
1457645434
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR L4631)
Enumeration Date
2011-06-07
Last Update Date
2017-01-30
Business Address
-- KELLY SULLIVAN MSW, LCSW
10883 SE MAIN ST STE. 204
MILWAUKIE, OR 97222-7641
Phone number: 503-381-2422
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Mailing Address
-- KELLY SULLIVAN MSW, LCSW
PO BOX 220203
PORTLAND, OR 97269-0203
Phone number: 503-381-2422
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