Individual
MS. MARY ELIZABETH SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISCW
Contact information
Practice address
123 GARDEN ST, NEEDHAM, MA 02492-2029
(781) 844-5037
Mailing address
123 GARDEN ST, NEEDHAM, MA 02492-2029
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
111047
MA
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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