| NPI | 1720410475 |
|---|---|
| Former Name | MARY SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: HI LMFT-351) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001310) |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2016-10-24 |