Individual
ANN C SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1095 PINGREE RD STE 209, CRYSTAL LAKE, IL 60014-1727
(847) 458-8890
Mailing address
1095 PINGREE RD STE 209, CRYSTAL LAKE, IL 60014-1727
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-390146
IL
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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