Individual
EILEEN SULLIVAN MIJARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
3042 CARLOW CIR, TALLAHASSEE, FL 32309-3303
(305) 968-1312
(850) 807-5114
Mailing address
3042 CARLOW CIR, TALLAHASSEE, FL 32309-3303
(305) 968-1312
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA7115
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889101000
—
FL
01
—
SA7115
FL DEPT OF HEALTH LIC
FL
Enumeration date
01/30/2007
Last updated
01/12/2022
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