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Contact Information

JILL M SULLIVAN, MS CCCSLP
307 CANON LANE
MALVERN, AR72104
 Phone: 501-605-7808
 Fax: 501-844-4434
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for JILL M SULLIVAN · (Female)

NPI # 1750330114
Status Active
Credentials MS CCCSLP
Entity Individual
Enumeration date 05/10/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • AR License # 739
  • AR Other 5X415 BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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