Organization
SOUTH COUNTY THERAPIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON SULLIVAN MA CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(774) 318-1900
Entity
Organization
Contact information
Practice address
176 MAIN ST STE 450, SOUTHBRIDGE, MA 01550-2565
(508) 314-6647
Mailing address
64 MAIN ST, STURBRIDGE, MA 01566-1244
(774) 318-1900
(774) 272-8810
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
5734
MA
Other
Enumeration date
06/14/2017
Last updated
05/08/2019
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