Sullivan, Mary J

Sullivan, Mary J is an individual health care provider with primary practice located at 95 Skowhegan Rd Maine Center For Integrated Rehab, Fairfield ME 04937-3303. 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, Mary J can be contacted via phone (207) 453-1330.

Contact Information

Primary practice address
95 Skowhegan Rd Maine Center For Integrated Rehab Fairfield ME 04937-3303
Phone: (207) 453-1330
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SP1885 Maine
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SP7845SL Massachusetts

Profile Details

NPI number 1215267554
LBN Legal business name Sullivan, Mary J
Credentials SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2010
Last updated Jan 8th, 2010 - about 16 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 1215267554 NPPES
Maine MEDICAID 433215399

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