Individual
TAYLOR ANNE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., ATC
Contact information
Practice address
421 N WOODLAND BLVD, UNIT 8284, DELAND, FL 32723-8300
(386) 822-7152
(386) 822-8143
Mailing address
421 N WOODLAND BLVD, UNIT 8284, DELAND, FL 32723-8300
(386) 822-7152
(386) 822-8143
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 4291
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL 4291
FLORIDA ATHLETIC TRAINING ASSOCIATION LINCENSURE
FL
Enumeration date
03/15/2016
Last updated
03/15/2016
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