Individual
DR. KELLY J. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
86 HUDSON ST, UNIT 3A, HOBOKEN, NJ 07030-5617
(917) 453-9377
Mailing address
61 5TH ST APT 3, HOBOKEN, NJ 07030-4964
(917) 453-9377
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
017207
NY
Other
Enumeration date
09/21/2007
Last updated
07/25/2011
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