Individual
SANDRA J SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
900 MAIN ST, OAKVILLE, CT 06779-1999
(860) 945-3012
(860) 945-9854
Mailing address
PO BOX 425, WATERTOWN, CT 06795-0425
(860) 945-3012
(860) 945-9854
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000778
CT
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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