Most Relevant Information
Provider Data
| NPI Number: | 1003325093 |
| Provider Name: | HEATHER MARIE SULLIVAN M.A.,CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/22/2017 |
| Last Updated: | 09/22/2017 |
Provider Practice Location
11244 WILLOW CREST LN
MOKENA
IL
604481334
Practice Location Phone/Fax
| Phone: | 7083424972 |
| Fax: |
Provider Mailing Location
9210 BIRCH AVE
MOKENA
IL
604488322
Provider Mailing Phone/Fax
| Phone: | 7088191547 |
| Fax: |