| NPI | 1629106315 |
|---|---|
| Former Name | JANICE G. SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C005536) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-1606) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2019-08-06 |