Individual
KRISTINE J. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3105 S SARE RD APT 300, BLOOMINGTON, IN 47401-4378
(812) 333-3939
(812) 585-3802
Mailing address
3105 S SARE RD APT 300, BLOOMINGTON, IN 47401-4378
(812) 333-3939
(812) 585-3802
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005593A
IN
Other
Enumeration date
10/07/2008
Last updated
12/14/2022
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