Individual provider · Type 1 NPI
Mallory Sullivan, 222Q00000X
Developmental Therapist · Magnolia, KY
Practice location
1745 Hammonsville Jonesville Rd
Magnolia, KY 42757-7643
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmental Therapist Primary | 222Q00000X | None listed |
Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…
Another provider at this address
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About NPI 1174013841
Mallory Sullivan, 222Q00000X's National Provider Identifier is 1174013841, issued on May 17, 2018. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Magnolia, KY. The record was last updated on May 17, 2018.