Individual
DINA JOSIF SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2903 FALLSTAFF RD UNIT 107, BALTIMORE, MD 21209-3555
(410) 615-9019
Mailing address
6308 GREENSPRING AVE, BALTIMORE, MD 21209-3202
(410) 615-9019
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC9572
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49903010800
—
MD
Enumeration date
06/24/2019
Last updated
09/12/2025
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