Individual
MS. KELLY G SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
321 BURNCOAT ST, WORCESTER, MA 01606-3141
(508) 853-2487
(508) 595-9712
Mailing address
321 BURNCOAT ST, WORCESTER, MA 01606-3141
(508) 853-2487
(508) 595-9712
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
214702
MA
Other
Enumeration date
05/30/2008
Last updated
05/30/2008
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