Individual
MS. MARILYN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1527 EMPIRE BLVD, WEBSTER, NY 14580-2103
(585) 670-0507
(585) 645-0939
Mailing address
1527 EMPIRE BLVD, WEBSTER, NY 14580-2103
(585) 670-0507
(585) 645-0939
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
F400291
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400291
NY
Other
Enumeration date
08/17/2006
Last updated
05/24/2021
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