Individual
CASSIDY E SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31741 RANCHO VIEJO RD, SAN JUAN CAPISTRANO, CA 92675-6722
(949) 613-9910
Mailing address
31741 RANCHO VIEJO RD, SAN JUAN CAPISTRANO, CA 92675-6722
(949) 613-9910
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
20437
CA
Other
Enumeration date
06/17/2013
Last updated
01/29/2014
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