Individual
MARY ALLISON SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.S.W.
Contact information
Practice address
25 WOODS LAKE RD STE 712, GREENVILLE, SC 29607-2765
(864) 334-7826
Mailing address
25 WOODS LAKE RD STE 712, GREENVILLE, SC 29607-2765
(864) 334-7826
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9910
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9910
SC SOCIAL WORK LICENSE
SC
Enumeration date
11/19/2008
Last updated
05/23/2022
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