Individual
MARTHA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16 KIDS PEACE WAY, ELLSWORTH, ME 04605-3483
(207) 667-0909
(207) 667-6348
Mailing address
PO BOX 787, ELLSWORTH, ME 04605-0787
(207) 667-0909
(207) 667-6348
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP969
ME
Other
Enumeration date
01/05/2011
Last updated
01/05/2011
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