Individual
MS. DIANE MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
118 CENTRAL ST, WALTHAM, MA 02453-5465
(781) 891-0556
Mailing address
35 CLAREMONT AVE, ARLINGTON, MA 02476-5811
(781) 891-0556
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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