Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 114138-SW-LICSW | MA |
NPI | 1225512320 |
---|---|
Provider Name | Katherine Sullivan-Maher |
First Address | Milton, MA 02186-1606 |
Second Address | Milton, MA 02186-1606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2018 |
Last Update Date | 24/09/2018 |