Individual
DR. MICHAEL FRANCIS SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1500 UNIVERSITY AVE W, SUITE 200, SAINT PAUL, MN 55104-3908
(651) 769-4804
Mailing address
1500 UNIVERSITY AVE W, SUITE 200, SAINT PAUL, MN 55104-3908
(651) 769-4804
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2038
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
488850200
—
MN
Enumeration date
12/28/2006
Last updated
06/04/2015
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