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Individual
MS. MARIE L SULLIVAN
Active
Individual
MS. MARIE L SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1025358
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
294153
BCBS
RI
01
—
350274
MBH
MA
01
—
P07881
BCBS
MA
Enumeration date
03/18/2006
Last updated
07/08/2007
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