| NPI | 1508517327 |
|---|---|
| Other Name | KASSIE SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 106862) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO 09923208) |
| 1041C0700X Social Worker, Clinical (Licence: MT 6905) | |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2022-01-13 |