National Provider Identifier

Michelle K Sullivan, M.S.CCC-SLP

Michelle K Sullivan, M.S.CCC-SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Jasper, NY and a listed phone number of (607) 792-3675.

NPI 1023120730Jasper, NYSpeech-Language Pathologist

Profile Overview

NPI
1023120730
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
August 31, 2006
Last Updated
March 24, 2016

Practice Location

  • 3769 Ny-417
  • Jasper, NY 14855

Phone: (607) 792-3675

Mailing Address

  • 347 S Division St
  • Hornell, NY 14843-2135

Specialties

  • Speech-Language Pathologist (235Z00000X)
  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1023120730
Entity Type
Individual
Last Name
Sullivan
First Name
Michelle
Middle Name
K
Name Prefix
Mrs.
Credential
M.S.CCC-SLP
Mailing Street Address
347 S Division St
Mailing City
Hornell
Mailing State
NY
Mailing ZIP Code
14843-2135
Mailing Country
US
Mailing Phone
(607) 654-0062
Practice Street Address
3769 Ny-417
Practice City
Jasper
Practice State
NY
Practice ZIP Code
14855
Practice Country
US
Practice Phone
(607) 792-3675
Enumeration Date
August 31, 2006
Last Updated
March 24, 2016
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X), Speech-Language Pathologist (235Z00000X)
Other Identifiers
8911096 00 (FL)