Individual
SHANE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MT-BC
Contact information
Practice address
122 WINDSOR AVE FL 2, MERIDEN, CT 06451-2900
(860) 222-5332
Mailing address
122 WINDSOR AVE FL 2, MERIDEN, CT 06451-2900
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
—
—
Other
Enumeration date
08/10/2017
Last updated
08/10/2017
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