Individual
NICOLE ANN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
56 W MAIN ST, PLAINVILLE, CT 06062-1904
(860) 351-5407
Mailing address
31 TOWER RD, MANCHESTER, CT 06042-2830
(860) 803-6618
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
11/13/2018
Last updated
07/20/2021
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