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Individual

MRS. LAUREN RODDY SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
3001 SPRING FOREST RD, RALEIGH, NC 27616-2815
(919) 424-5080
Mailing address
9184 BEAVERDAM TRL, MECHANICSVILLE, VA 23116-3913
(870) 761-5991

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131-001982
VA

Other

Enumeration date
06/25/2018
Last updated
06/25/2018
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