Individual
SULLIVAN JAMES KILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
470 SIAS AVE, NEWPORT, VT 05855-5872
(802) 585-3212
Mailing address
PO BOX 248, WATERBURY CENTER, VT 05677-0248
(541) 408-7209
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
03/22/2024
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