Individual
KAMMIE LYNNETTE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
200 E NORTH AVE, BALTIMORE, MD 21202-4888
(443) 984-2000
Mailing address
5 NEAROCK CT, OWINGS MILLS, MD 21117-3218
(443) 695-5434
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
03587
MD
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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