Individual
KYLEE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
400 N EASTERN AVE, MOORE, OK 73160-5833
(580) 367-0041
Mailing address
400 N EASTERN AVE, MOORE, OK 73160-5833
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/03/2019
Last updated
04/03/2019
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