Individual
MELISSA JANE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
44444 MOUND RD STE 610, STERLING HEIGHTS, MI 48314
(586) 307-4757
Mailing address
920 HARCOURT RD, GROSSE POINTE PARK, MI 48230-1874
(313) 510-6381
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101006208
MI
Other
Enumeration date
08/23/2017
Last updated
10/25/2019
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