Provider Demographics
NPI:1386110120
Name:CULLEN, SONDRA
Entity type:Individual
Prefix:
First Name:SONDRA
Middle Name:
Last Name:CULLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SONDRA
Other - Middle Name:
Other - Last Name:MCADAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:93 OLD MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:NH
Mailing Address - Zip Code:03033
Mailing Address - Country:US
Mailing Address - Phone:203-331-7026
Mailing Address - Fax:
Practice Address - Street 1:93 OLD MILFORD RD
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:NH
Practice Address - Zip Code:03033
Practice Address - Country:US
Practice Address - Phone:203-331-7026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-19
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NH256101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor