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Individual

ANTOINETTE GRACE SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
3000 C ST STE 102, ANCHORAGE, AK 99503-3975
(907) 729-8558
Mailing address
7033 E TUDOR RD, ANCHORAGE, AK 99507-1262
(907) 729-6801
(907) 729-5180

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
213488
AK
172V00000X
Community Health Worker
Primary
213488
AK

Other

Enumeration date
08/13/2024
Last updated
04/10/2026
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