Sullivan, Glinda Mae
Sullivan, Glinda Mae is an sole proprietor health care provider with primary practice located at 106 4 Seasons Ctr Suite 106C, Chesterfield MO 63017-3173. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Sullivan, Glinda Mae can be contacted via phone (573) 528-7569.Contact Information
Primary practice address
106 4 Seasons Ctr Suite 106C
Chesterfield MO 63017-3173
Phone: (573) 528-7569
Fax: (314) 439-5036
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2004024741 | Missouri |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 071.007644 | Illinois |
Profile Details
| NPI number | 1679793897 |
|---|---|
| LBN Legal business name | Sullivan, Glinda Mae |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 27th, 2007 |
| Last updated | Jul 23rd, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679793897 | NPPES |
| Missouri | MEDICAID | 499462307 |
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