Individual
MRS. AGNES SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, MSC, BSC
Contact information
Practice address
8546 115TH ST, RICHMOND HILL, NY 11418-1732
(858) 342-5753
Mailing address
8546 115TH ST, RICHMOND HILL, NY 11418-1732
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
076573
NY
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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