Individual
MRS. LOUISE MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
576 5TH AVE, TROY, NY 12182-2536
(518) 233-6822
Mailing address
23 WILLOWDALE TER, ALBANY, NY 12205-1923
(518) 459-3997
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
004704
NY
Other
Enumeration date
01/18/2013
Last updated
01/18/2013
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