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1700130267
MARALISSA A SULLIVAN
FORT WAYNE, IN
NPI
1700130267
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2012-11-06
Last Update Date
2012-11-06
Business Address
-- MARALISSA A SULLIVAN MS
909 E STATE BLVD
FORT WAYNE, IN 46805-3404
Phone number: 260-481-2700
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Mailing Address
-- MARALISSA A SULLIVAN MS
909 E STATE BLVD
FORT WAYNE, IN 46805-3404
Phone number: 260-481-2700
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