Individual
TAYA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 GROVE PARK LN STE 110, DOTHAN, AL 36305-5912
(334) 305-0297
Mailing address
200 GROVE PARK LN, DOTHAN, AL 36305-5911
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/01/2023
Last updated
03/01/2023
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