Individual
EMILY MAE SULLIVAN
Active
Individual
EMILY MAE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
261129
MA
390200000X
Student in an Organized Health Care Education/Training Program
252335
MA
Other
Enumeration date
06/18/2012
Last updated
02/01/2016
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