Individual
MRS. AMBER KAY SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
13428 MOUNT TABOR RD, ODESSA, MO 64076-7444
(816) 230-0026
Mailing address
13428 MOUNT TABOR RD, ODESSA, MO 64076-7444
(816) 230-0026
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2000167733
MO
Other
Enumeration date
03/22/2013
Last updated
03/22/2013
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