Individual
DR. KELLI LYNN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
146 WEST RIVER STREET SUITE 11A, PROVIDENCE, RI 02904
(401) 793-4006
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
Primary
PS02160
RI
Other
Enumeration date
05/08/2023
Last updated
09/11/2023
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