Individual
GERALD P. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC 1
Contact information
Practice address
8 FARNHAM ST, BOSTON, MA 02119-2908
(617) 971-9360
Mailing address
8 FARNHAM ST, BOSTON, MA 02119-2908
(617) 971-9360
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
134
MA
Other
Enumeration date
07/25/2016
Last updated
07/25/2016
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