Individual
KELLY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14105 SNOW RD, BROOKPARK, OH 44142-2557
(216) 676-4334
Mailing address
34918 CAMBRIDGE DR, NORTH RIDGEVILLE, OH 44039-3981
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-7193
OH
Other
Enumeration date
10/29/2014
Last updated
10/29/2014
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