Ebony Sullivan

NPI #1083308506 in Tulsa, Oklahoma

Provider Information

NPI Number: 1083308506
Entity Type: Individual
Name: Ebony Sullivan
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Jun 7, 2023
Last Updated: Jun 7, 2023

Practice Location

Address: 4515 E 91ST ST
City: Tulsa
State: Oklahoma
ZIP Code: 74137-2861
Phone: (855) 782-7822

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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