| Dominique Sulla, | |
|
1360 Porter St, Dearborn, MI 48124-2890 | |
| (313) 689-5188 | |
| Not Available |
| Full Name | Dominique Sulla |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 1360 Porter St, Dearborn, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225513716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 7152000240 (Michigan) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
| Provider Name | Game Changer Pediatric Therapy Services LLC |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1437506383 PECOS PAC ID: 5193017119 Enrollment ID: O20160713000040 |
| Provider Name | Behavioral Outcomes Management,llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1184139131 PECOS PAC ID: 1355602426 Enrollment ID: O20180306002107 |
| Mailing Address | Practice Location Address |
|---|---|
| Dominique Sulla, 1360 Porter St, Dearborn, MI 48124-2890 Ph: (313) 689-5188 | Dominique Sulla, 1360 Porter St, Dearborn, MI 48124-2890 Ph: (313) 689-5188 |
Chitter Chatter P.c. Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1360 Porter St Ste 100, Dearborn, MI 48124 Phone: 313-689-5188 |
Leanne Kathleen Marentay, MA, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 18501 Rotunda Dr Ste 100, Dearborn, MI 48124 Phone: 313-608-2244 Fax: 313-996-1935 |
Mr. Caleb Carter, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 24701 Riverdale St, Dearborn, MI 48124 Phone: 313-207-4778 |
Kathryn Kaufmann, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3101 S Gulley Rd Ste F-g, Dearborn, MI 48124 Phone: 734-407-2500 |
Theresa Marie Saporito, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1360 Porter St, Dearborn, MI 48124 Phone: 313-689-5188 |
Divya Parekh, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 23500 Park St # 3b, Dearborn, MI 48124 Phone: 313-694-7700 |
Meredith Friend Delcampo, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 18501 Rotunda Dr Ste 100, Dearborn, MI 48124 Phone: 313-996-1930 |