MS. Jacquelyn Ruth Sullivan, LCSW

NPI #1952406282 in Sidney, New York

Provider Information

NPI Number: 1952406282
Entity Type: Individual
Name: MS. Jacquelyn Ruth Sullivan, LCSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Sep 13, 2006
Last Updated: Jul 27, 2011

Practice Location

Address: 76 MAIN STREET
Address 2: SUITE B
City: Sidney
State: New York
ZIP Code: 13838
Phone: (607) 563-4080

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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