Most Relevant Information
Provider Data
| NPI Number: | 1003288796 |
| Provider Name: | MICHAEL ROBERT SULLIVAN MSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | CG60648868 |
Most Important Dates
| Enumeration Date: | 10/21/2015 |
| Last Updated: | 04/22/2022 |
Provider Practice Location
107 S DIVISION ST
SPOKANE
WA
992021510
Practice Location Phone/Fax
| Phone: | 5098384651 |
| Fax: |
Provider Mailing Location
107 S DIVISION ST
SPOKANE
WA
992021510
Provider Mailing Phone/Fax
| Phone: | 5098384651 |
| Fax: |