Individual
PATRICIA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS-SLP
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
(701) 364-8906
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55850
—
ND
Enumeration date
06/30/2011
Last updated
11/10/2011
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