Individual
MARSHA SULLIVAN-JAMETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
295 PHALEN BLVD., ST. PAUL, MN 55485-3969
(651) 254-3200
Mailing address
985450 NEBRASKA MED CTR, OMAHA, NE 68198-5450
(402) 559-8943
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
65
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025289000
—
NE
Enumeration date
11/02/2006
Last updated
11/28/2017
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