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Individual

SHANNON SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1159 S CARNEY DR, SAINT CLAIR, MI 48079-5569
(810) 487-5571
Mailing address
5451 HAMPTON PL, SAGINAW, MI 48604-9284

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401002983
MI
106S00000X
Behavior Technician

Other

Enumeration date
07/21/2025
Last updated
08/26/2025
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