Individual
LEE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
280 MT HEBRON RD, ELMORE, AL 36025-1526
(334) 567-8484
Mailing address
280 MT HEBRON RD, ELMORE, AL 36025-1526
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3744
AL
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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