Healthcare Provider Details

I. General information

NPI: 1922923010
Provider Name (Legal Business Name): ALEXANDRA RANGELEY SULLIVAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8315 SUNSET VIEW CT
BROWNS SUMMIT NC
27214-9809
US

IV. Provider business mailing address

8315 SUNSET VIEW CT
BROWNS SUMMIT NC
27214-9809
US

V. Phone/Fax

Practice location:
  • Phone: 336-639-1344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: