Individual
EMILY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4755 FOXBERRY DR, MEDINA, MN 55340-4611
(952) 807-2519
Mailing address
4755 FOXBERRY DR, MEDINA, MN 55340-4611
(952) 807-2519
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202745
MN
Other
Enumeration date
06/24/2020
Last updated
01/10/2023
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