Kelly Sullivan
Speech-Language Pathologist, in Beverly, MA. Individual provider (NPI-1).
NPI number1699375899
StatusActive
Last updated in NPPESOct 15, 2024
Details
- NPI
- 1699375899
- Entity type
- Individual (NPI-1)
- Name
- Kelly Sullivan
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 27, 2020
- Certification date
- Oct 15, 2024
- Last updated
- Oct 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 77836-SP-SL | MA | Yes |
Practice location
100 Cummings Ctr Ste 135hBeverly, MA 01915-6127
Phone 978-927-0172
Mailing address
200 Presidential Way Unit 2113Woburn, MA 01801-1298
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