Individual
KELLY SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
808 BACON ST, DURHAM, NC 27703-5006
(919) 560-2000
Mailing address
808 BACON ST, DURHAM, NC 27703-5006
(919) 560-2000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11308
NC
Other
Enumeration date
04/24/2015
Last updated
04/10/2026
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