Individual
MARY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
2550 UNIVERSITY AVE W, SUITE 310N, SAINT PAUL, MN 55114-1052
(651) 379-5157
Mailing address
1008 31ST AVE N, MINNEAPOLIS, MN 55411-1329
(612) 529-4311
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
LP3263
MN
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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