Therese Sullivan, OTR

NPI #1518191907 in Granger, Indiana

Provider Information

NPI Number: 1518191907
Entity Type: Individual
Name: Therese Sullivan, OTR
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: OTR
Enumeration Date: May 13, 2009
Last Updated: May 13, 2009

Practice Location

Address: 15802 CEDAR RIDGE CT
City: Granger
State: Indiana
ZIP Code: 46530-6516
Phone: (574) 243-2487

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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