Provider Demographics
NPI:1144016072
Name:SULLIVAN, ANSLEY MORGAN
Entity type:Individual
Prefix:
First Name:ANSLEY
Middle Name:MORGAN
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 ASH BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:GA
Mailing Address - Zip Code:31321-4580
Mailing Address - Country:US
Mailing Address - Phone:912-657-1648
Mailing Address - Fax:
Practice Address - Street 1:25 CASSIDY DR
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4143
Practice Address - Country:US
Practice Address - Phone:843-396-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist