| Doctor Name: | MRS. MICHELLE K SULLIVAN |
| NPI Number: | 1023120730 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. CCC-SLP |
| License Number: | SA 8194 |
| Business Practice Address: | 3769 Ny-417 Jasper, NY - 14855 |
| Business Phone Number: | 6077923675 |
| Business Fax Number: | |
| Mailing Address: | 347 S Division St, HORNELL |
| State: | NY |
| Postal Code: | 148432135 |
| Phone Number: | 6076540062 |
| Fax Number: | |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 03/24/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA 8194 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |