Individual
AMYLLA SULLANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
280 N MAIN ST, BOUNTIFUL, UT 84010-6136
(833) 577-3422
Mailing address
280 N MAIN ST, BOUNTIFUL, UT 84010-6136
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12331195-4108
UT
Other
Enumeration date
03/16/2022
Last updated
03/16/2022
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