Individual
MADISON NICHOLE OSULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
54 RED MULBERRY WAY, LILLINGTON, NC 27546-9633
(910) 814-8030
Mailing address
6741 BROMWICH LN APT 301, RALEIGH, NC 27607-5284
(910) 787-8513
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
14824
NC
Other
Enumeration date
02/25/2022
Last updated
02/25/2022
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