Individual
MS. MARY KATHERINE ELIZABETH SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LICSW
Contact information
Practice address
1204 VENDOME DR W, MOBILE, AL 36609-3326
(504) 345-8537
Mailing address
1204 VENDOME DR W, MOBILE, AL 36609-3326
(504) 345-8537
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904016013
VA
1041C0700X
Clinical Social Worker
112281
TX
1041C0700X
Clinical Social Worker
15192
LA
1041C0700X
Clinical Social Worker
Primary
5027C
AL
Other
Enumeration date
07/21/2021
Last updated
05/23/2024
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