| NPI | 1629612965 |
|---|---|
| Former Name | MOLLY ELAINE SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PA OC016609) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: DE U1-0002094) |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |