Individual
ELIZABETH SULLIVAN-WELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
145 GROVE ST, WATERBURY, CT 06710-2202
(203) 753-7205
Mailing address
35 NATHAN CT, WATERBURY, CT 06708-1917
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
000788
CT
225XM0800X
Mental Health Occupational Therapist
Primary
000788
CT
Other
Enumeration date
06/19/2013
Last updated
06/25/2013
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