Individual
MS. ELLEN MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3440 AIRWAY DR, SUITE E, SANTA ROSA, CA 95403-2065
(707) 544-3299
(707) 544-6837
Mailing address
3440 AIRWAY DR, SUITE E, SANTA ROSA, CA 95403-2065
(707) 544-3299
(707) 544-6837
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/19/2010
Last updated
04/19/2010
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