Individual
MS. JOANNA KATHLEEN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
112 HOLT DR, MADISON, IN 47250-3873
(812) 265-8227
Mailing address
312 CRAGMONT ST, MADISON, IN 47250-3007
(812) 265-4788
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
332006
IN
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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