Individual
BRIGITTE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSSA, LSW
Contact information
Practice address
310 GRACE AVE, FAIRVIEW, PA 16415-1445
(814) 520-4903
Mailing address
310 GRACE AVE, FAIRVIEW, PA 16415-1445
(814) 520-4903
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW125052
PA
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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