Sullivan, Miya Venetia

Sullivan, Miya Venetia is an sole proprietor health care provider with primary practice located at 3672 W Pine Mall Blvd Athletics, Saint Louis MO 63108-3304. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Sullivan, Miya Venetia can be contacted via phone (314) 977-7024.

Contact Information

Primary practice address
3672 W Pine Mall Blvd Athletics Saint Louis MO 63108-3304
Phone: (314) 977-7024
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 2000170998 Missouri

Profile Details

NPI number 1649488503
LBN Legal business name Sullivan, Miya Venetia
Credentials MS, ATC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 21st, 2007
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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