Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mallory Sullivan, 222Q00000X

Individual provider Developmental Therapist · NPI 1174013841

Mallory Sullivan, 222Q00000X is a Developmental Therapist in Magnolia, Kentucky. Practices as a sole proprietor. Licensed in Kentucky.

Licensed in
KY
In the registry since
2018
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Practice location Address checks out

1745 Hammonsville Jonesville Rd
Magnolia, KY 42757-7643
Phone: (270) 766-7598
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Developmental Therapist (primary) Taxonomy 222Q00000X (KY)

Record details

NPI number1174013841
Entity typeIndividual (Type 1)
GenderFemale
Credentials 222Q00000X
Sole proprietorYes
NPI enumeratedMay 17, 2018
Last updated in NPPESMay 17, 2018

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