Individual
MISS JENNIFER R SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
161 HERBERT AVE, FANWOOD, NJ 07023
(908) 889-5309
Mailing address
161 HERBERT AVE, FANWOOD, NJ 07023-1643
(908) 889-5309
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0179561
NY
Other
Enumeration date
04/08/2009
Last updated
12/08/2016
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