Individual
DONNA-SUE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COMS, CLVT
Contact information
Practice address
115 VITAL ST, LAFAYETTE, LA 70506-5440
(225) 278-3361
Mailing address
115 VITAL ST, LAFAYETTE, LA 70506-5440
(225) 278-3361
Taxonomy
Speciality
Code
Description
License number
State
2255R0406X
Blind Rehabilitation Specialist/Technologist
Primary
1524
LA
2255R0406X
Blind Rehabilitation Specialist/Technologist
5040
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699839944
LOUISIANA ASSOCIATION FOR THE BLIND
LA
Enumeration date
02/04/2020
Last updated
02/04/2020
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