Individual
BONNIE ELIZABETH SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCS
Contact information
Practice address
3840 BAYS FERRY TRL, MARIETTA, GA 30062-5287
(678) 560-5458
(678) 560-5458
Mailing address
3840 BAYS FERRY TRL, MARIETTA, GA 30062-5287
(678) 560-5458
(678) 560-5458
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R058997-1
NY
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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