Individual
AMANDA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
1400 VFW PKWY, WEST ROXBURY, MA 02132-4927
(857) 203-6584
(857) 203-5680
Mailing address
42 ASHLAND ST, TAUNTON, MA 02780-3125
(508) 386-2884
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9241
MA
Other
Enumeration date
02/04/2008
Last updated
04/05/2016
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