Individual
KRISTINA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2906 HIGHWAY AVE, HIGHLAND, IN 46322-1631
(311) 219-5138
Mailing address
9202 WAYMOND AVE, HIGHLAND, IN 46322-2521
(219) 200-8135
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BCBA-1-22-60094
—
106S00000X
Behavior Technician
RBT-16-24535
IN
Other
Enumeration date
11/08/2019
Last updated
07/01/2022
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