Individual
PAULINE M. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
1815 N BROADWAY APT 66, ESCONDIDO, CA 92026-2066
(442) 300-4934
Mailing address
PO BOX 552, ESCONDIDO, CA 92033-0552
(442) 300-4934
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LMHC-4366
MA
101YP2500X
Professional Counselor
Primary
LPC-18621
AZ
Other
Enumeration date
06/23/2009
Last updated
07/03/2023
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