Individual
MS. LISA KAY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
505 S MAIN ST, STE 249, LAS CRUCES, NM 88001-1206
(575) 527-5884
(575) 527-5886
Mailing address
505 S MAIN ST, STE 249, LAS CRUCES, NM 88001-1206
(575) 527-5884
(575) 527-5886
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C-5129
NM
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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