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: |