Individual
SHANNON SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
64 MAIN ST, STURBRIDGE, MA 01566-1244
(774) 318-1900
(774) 272-8810
Mailing address
64 MAIN ST, STURBRIDGE, MA 01566-1244
(774) 318-1900
(774) 272-8810
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5734
MA
Other
Enumeration date
08/25/2015
Last updated
05/08/2019
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