Most Relevant Information
Provider Data
NPI Number: | 1003533738 |
Provider Name: | RYLAN SULLIVAN LMSW |
Entity Type: | Individual |
Taxonomy Code: | 104100000X |
Specialty: | Social Worker |
License Number: |
Most Important Dates
Enumeration Date: | 10/24/2022 |
Last Updated: | 10/24/2022 |
Provider Practice Location
20 TUTTLE PL STE 4
MIDDLETOWN
CT
064571870
Practice Location Phone/Fax
Phone: | 8606323231 |
Fax: |
Provider Mailing Location
20 TUTTLE PL STE 4
MIDDLETOWN
CT
064571870
Provider Mailing Phone/Fax
Phone: | |
Fax: |