Sullivan, Jill Marie

Sullivan, Jill Marie is an individual health care provider with primary practice located at 307 Canon Lane , Malvern AR 72104. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Sullivan, Jill Marie can be contacted via phone (501) 605-7808.

Contact Information

Primary practice address
307 Canon Lane Malvern AR 72104
Fax: (501) 844-4434
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 739 Arkansas

Profile Details

NPI number 1750330114
LBN Legal business name Sullivan, Jill Marie
Credentials MS CCCSLP
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750330114 NPPES
Arkansas Other 5X415 BCBS

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