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Individual

ELIZABETH MARIE SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1000 EDDY ST, PROVIDENCE, RI 02905-4739
(401) 533-9100
Mailing address
1000 EDDY ST, PROVIDENCE, RI 02905-4739
(401) 533-9100

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT01159
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2058
NHPRC
RI
01
2092
EI NHPRC
RI
01
292177
EI BCROSS
RI
01
412296
EI BCHIP
RI
01
6400144
UNITED
RI
05
9009994
RI
01
99947
BCROSS
RI
05
ES01788
RI
Enumeration date
08/27/2007
Last updated
01/15/2008
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