Individual
KENLEY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
950 N FEDERAL HWY STE 216, POMPANO BEACH, FL 33062-4328
(954) 533-7705
(954) 533-7705
Mailing address
20789 NW 3RD CT, PEMBROKE PINES, FL 33029-3519
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY10013
FL
Other
Enumeration date
01/26/2018
Last updated
01/26/2018
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