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Individual

DR. SUSAN SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1970 MICHIGAN AVE, BLDG. C-1, COCOA, FL 32922-5758
(321) 209-1871
Mailing address
801 SE JOHNSON AVE, #138, STUART, FL 34995-5001
(772) 349-1871

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY8490
FL

Other

Enumeration date
12/28/2009
Last updated
01/22/2013
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