Individual
MS. MARY SHEILA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, RD, CSR, LDN
Contact information
Practice address
16 RAYMOND DR, WILBRAHAM, MA 01095-2606
(413) 537-2426
Mailing address
16 RAYMOND DR, WILBRAHAM, MA 01095-2606
(413) 537-2426
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
121
MA
133VN1005X
Renal Nutrition Registered Dietitian
Primary
121
MA
Other
Enumeration date
09/27/2016
Last updated
09/27/2016
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