Individual
LYDIA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
721 SOUTH BLVD, SUITE 210, OAK PARK, IL 60302-2982
(312) 404-7225
Mailing address
311 WYCKOFF AVE, RAMSEY, NJ 07446-2251
(845) 893-0066
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
11623077
IL
103K00000X
Behavior Analyst
Primary
11623077
NJ
Other
Enumeration date
10/21/2016
Last updated
02/25/2022
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