| Doctor Name: | MS. EVA LUKKONEN SULLIVAN |
| NPI Number: | 1518107036 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MM MA CCC-SLP |
| License Number: | SLP007119 |
| Business Practice Address: | 247 Jackson St Lawrenceville, GA - 300465705 |
| Business Phone Number: | 6788256411 |
| Business Fax Number: | 6787967611 |
| Mailing Address: | 247 Jackson St, LAWRENCEVILLE |
| State: | GA |
| Postal Code: | 300465705 |
| Phone Number: | 6788256411 |
| Fax Number: | 6787967611 |
| NPI Enumeration Date: | 02/24/2009 |
| NPI Last Update Date: | 04/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP007119 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| 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 |