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Individual

LAURIE SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
112 INDUSTRY AVE, SPRINGFIELD, MA 01104-3349
(413) 205-0501
Mailing address
112 INDUSTRY AVE, SPRINGFIELD, MA 01104-3349
(413) 205-0501

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1030508
MA

Other

Enumeration date
08/24/2018
Last updated
08/24/2018
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