Individual
DR. GLINDA MAE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
106 4 SEASONS CTR, SUITE 106C, CHESTERFIELD, MO 63017-3173
(573) 528-7569
(314) 439-5036
Mailing address
106 4 SEASONS CTR, SUITE 106C, CHESTERFIELD, MO 63017-3173
(573) 528-7569
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071.007644
IL
103TC0700X
Clinical Psychologist
Primary
2004024741
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
499462307
—
MO
Enumeration date
04/27/2007
Last updated
07/23/2012
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