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Individual
MICHELLE PAMELA SULLIVAN
Active
Individual
MICHELLE PAMELA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-107206
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-19-107206
REGISTERED BEHAVIORAL TECHNICIAN
AL
Enumeration date
11/27/2019
Last updated
08/31/2020
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