Individual
LAUREN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 E LOGAN AVE, SALT LAKE CITY, UT 84108-2631
(603) 767-3632
Mailing address
1801 E LOGAN AVE, SALT LAKE CITY, UT 84108-2631
(603) 767-3632
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11696271-4201
UT
Other
Enumeration date
03/19/2021
Last updated
03/19/2021
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