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Individual

CHRISTINE LOUISE SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
1968 CENTRAL AVE, NEEDHAM, MA 02492-1410
(781) 292-2136
Mailing address
1968 CENTRAL AVE, NEEDHAM, MA 02492-1410
(781) 292-2136

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
111835
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1200925
MA
Enumeration date
09/14/2006
Last updated
10/03/2008
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