Individual
MRS. BETTY H SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2850 5TH AVE, HUNTINGTON, WV 25702-1436
(304) 528-5000
(304) 528-5080
Mailing address
265 S WALNUT ST, HUNTINGTON, WV 25705-3511
(304) 528-5175
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0153119000
—
WV
Enumeration date
02/07/2008
Last updated
02/07/2008
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