Individual
KIMBERLY NICOLE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
110 CORNING RD, CARY, NC 27518-9229
(919) 431-7400
Mailing address
273 WINDING CREEK DR, LILLINGTON, NC 27546-4888
(732) 439-5286
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
15473
NC
225XP0200X
Pediatric Occupational Therapist
Primary
15473
NC
Other
Enumeration date
11/28/2022
Last updated
04/13/2026
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