Individual
ELIZABETH SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
4224 HOLLAND RD STE 106, VIRGINIA BEACH, VA 23452-1900
(757) 416-5290
(757) 416-5290
Mailing address
4224 HOLLAND RD STE 106, VIRGINIA BEACH, VA 23452-1900
(757) 416-5290
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-15-9825-17396
VA
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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