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Search › Illinois › 103K00000X

Mandy Sullivan, BCBA

NPI 1992006621 · on the registry since 2010

Practice

Address
20 N 13th St
Murphysboro, IL 62966
Phone
(618) 687-2378
Fax
(618) 687-2733
Organisation at this address
Specialized Training For Adult Rehabilitation, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
3

Registry record

Primary taxonomy
103K00000X
103K00000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2018-05-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois