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Organization

SULLIVAN SPEECH LANGUAGE ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELIZABETH M. SULLIVAN M.A.CCCSLP (OWNER)
(406) 556-9853
Entity
Organization

Contact information

Practice address
720 STONERIDGE DR, SUITE 2, BOZEMAN, MT 59718-7032
(406) 556-9853
Mailing address
129 ERIK DR, BOZEMAN, MT 59715-1745
(406) 556-9853
(406) 586-2732

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP984
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0532474
MT
05
0534242
MT
05
0535347
MT
01
660570
BCBS ELIZABETH SULLIVAN
MT
01
662040
BCBS NICHOLE SCALA ASSOCI
MT
01
662830
BCBS CHERI SORG HACKLER
MT
Enumeration date
03/25/2007
Last updated
08/22/2020
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