Individual
MRS. DIANA ROSE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
283 POMEROY AVE, PITTSFIELD, MA 01201-6416
(413) 358-5927
Mailing address
283 POMEROY AVE, PITTSFIELD, MA 01201-6416
(413) 358-5927
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/20/2012
Last updated
06/20/2012
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