Individual
DIANE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1 LOVE LN, SOUTH DENNIS, MA 02660-3445
(508) 385-6034
Mailing address
76 TUPPER RD UNIT 1, SANDWICH, MA 02563-2075
(203) 565-3222
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
000873
CT
224Z00000X
Occupational Therapy Assistant
Primary
4326
MA
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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