Individual
MARK PATRICK SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3165 MCKELVEY RD, SUITE 200, BRIDGETON, MO 63044-2550
(314) 206-3400
Mailing address
3165 MCKELVEY RD, SUITE 200, BRIDGETON, MO 63044-2550
(314) 206-3400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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