Individual
KATHLEEN E SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
12 BEACH ST, SACO, ME 04072-2802
(207) 283-3846
(207) 284-8106
Mailing address
899 RIVERSIDE ST, PORTLAND, ME 04103-1070
(207) 871-1200
(207) 871-1232
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC1988
ME
Other
Enumeration date
11/08/2007
Last updated
11/08/2007
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