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Individual

MAKENNA SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
5079 SCOTTSVILLE RD, BOWLING GREEN, KY 42104-7897
(270) 782-1125
Mailing address
2075 GREATHOUSE RD, BOWLING GREEN, KY 42103-9079
(763) 370-0190

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
266361
KY

Other

Enumeration date
09/29/2020
Last updated
09/29/2020
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