Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1164991204 |
---|---|
Provider Name | Ellen Maura Sullivan |
First Address | Hingham, MA 02043-4837 |
Second Address | Hingham, MA 02043-4837 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2018 |
Last Update Date | 19/11/2018 |