Individual
KAITLIN O'SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2122 SPRUCE ST APT 301, PHILADELPHIA, PA 19103-2556
(585) 339-8062
Mailing address
2122 SPRUCE ST APT 301, PHILADELPHIA, PA 19103-2556
(585) 339-8062
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL012091
PA
Other
Enumeration date
10/29/2014
Last updated
10/29/2014
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