Individual
DENAE MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
707 LINDEN DR, JEFFERSON CITY, MO 65109-2742
(573) 632-3499
Mailing address
300 N STARDUST LN, COLUMBIA, MO 65201-6957
(816) 387-1297
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2015028977
MO
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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