Individual
SUSAN ELIZABETH SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
13 WELBY ROAD, SUITE 2, NEW BEDFORD, MA 02745-1132
(508) 998-1115
(508) 998-1140
Mailing address
13 WELBY ROAD, SUITE 2, NEW BEDFORD, MA 02745-1132
(508) 998-1115
(508) 998-1140
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2364
MA
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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