Individual
DR. ANNA CAMPBELL SULLIVAN
Active
Individual
DR. ANNA CAMPBELL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
05354
MD
103G00000X
Clinical Neuropsychologist
Primary
37406
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
362091601
—
TX
01
—
362091602
CSHCN
TX
Enumeration date
04/05/2011
Last updated
10/13/2016
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