Provider Demographics
NPI:1437805371
Name:SULLIVAN ROBBINS, JESSICA (HADE11185)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SULLIVAN ROBBINS
Suffix:
Gender:F
Credentials:HADE11185
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7904 E CHAPARRAL RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7210
Mailing Address - Country:US
Mailing Address - Phone:480-947-2829
Mailing Address - Fax:
Practice Address - Street 1:7904 E CHAPARRAL RD STE 106
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-7210
Practice Address - Country:US
Practice Address - Phone:480-947-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHADE11185237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist