Individual
CIERRA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
207 N MAPLE ST STE 12, SIMPSONVILLE, SC 29681-2338
(864) 320-7244
Mailing address
2 PARADE DR, GREENVILLE, SC 29605-2751
(864) 363-9782
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3706
SC
Other
Enumeration date
01/25/2019
Last updated
01/25/2019
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