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Individual

NEVA JOYCE SULLINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTRL

Contact information

Practice address
108 BALDRIDGE DRIVE, COTTONTOWN, TN 37048
(615) 415-4002
(615) 672-0756
Mailing address
108 BALDRIDGE DRIVE, COTTONTOWN, TN 37048
(615) 415-4002
(615) 672-0756

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
KY-R0350
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
KY-R0350
OCCUPATIONAL THERAPIST
KY
Enumeration date
10/02/2006
Last updated
07/08/2007
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