Individual
KELLY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 CUMMINGS CTR STE 135H, BEVERLY, MA 01915-6127
(978) 927-0172
Mailing address
200 PRESIDENTIAL WAY UNIT 2113, WOBURN, MA 01801-1298
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
77836-SP-SL
MA
Other
Enumeration date
10/27/2020
Last updated
10/15/2024
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