Individual
MRS. SHAUNA BETH SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3519 SILVERSIDE RD, RIDGELY BUILDING, SUITE 103, WILMINGTON, DE 19810-4909
(302) 383-6826
Mailing address
3519 SILVERSIDE RD, RIDGELY BUILDING, SUITE 103, WILMINGTON, DE 19810-4909
(302) 383-6826
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
Q1-0000884
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
239250
—
DE
Enumeration date
07/03/2007
Last updated
02/06/2012
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