Individual
CHELSEA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
301 PERKINS DR STE B, LAS CRUCES, NM 88005-3248
(575) 652-3155
(575) 652-4104
Mailing address
511 LINDEN AVE, NICEVILLE, FL 32578-3363
(850) 855-8635
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14316
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
57229279
—
NM
Enumeration date
02/09/2016
Last updated
02/22/2019
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