MEDICARE: DOLORES ARLT SULLIVAN SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	4028	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	AZ0308030	OTHER	AZ	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1275757460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOLORES ARLT SULLIVAN SLP

Provider Business Mailing Address
First Line	:	PO BOX 3327
Second Line	:
City	:	GALLUP
State	:	NM
Zip	:	87305-3327
Country	:	US
Telephone Number	:	505-863-8887
Fax Number	:	928-871-2837

Provider Business Practice Location Address
First Line	:	1 MI N OF 264 MUSTANG ROAD
Second Line	:
City	:	ST. MICHAELS
State	:	AZ
Zip	:	86511-0100
Country	:	US
Telephone Number	:	928-871-2822
Fax Number	:	928-871-2837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1235353806 — ST. MICHAELS ASSOCIATION FOR SPECIAL EDUCATION
Practice Location Address:

1 MILE NORTH OF RT. 264 ON MUSTANG ROAD
ST. MICHAELS, AZ
86511-0100

Practice Phone: 928-871-2822
Practice Fax:

1417171810 — MS. PATRICIA F HOGAN LCSW, LMT
Practice Location Address:

MUSTANG ROAD 1 MILE NORTH OF RT 264 , ST MICHAELS ASSOC FOR SPECIAL EDUCATION
ST MICHAELS, AZ
86511-0100

Practice Phone: 928-871-2899
Practice Fax: 928-871-4873

1124249362 — AMANDA L BEEKMAN MA, OTRL
Practice Location Address:

MUSTANG RD ONE MILE NORTH OF HWY 264
ST MICHAELS, AZ
86511-0100

Practice Phone: 928-871-2822
Practice Fax: 928-871-2837

1215144290 — MS. PAULINE ANNE BOISSELLE OTR
Practice Location Address:

ST. MICHAELS ASSOCIATION OF SPECIAL EDUCATION , 1 MILE N OF 264 MUSTANG ROAD
ST. MICHAELS, AZ
86511-0100

Practice Phone: 928-871-2812
Practice Fax:

1639362551 — MELVINA E. BIGTHUMB M.S.
Practice Location Address:

MUSTANG RD. 1 MI. N. OF HIGHWAY 264
ST MICHAELS, AZ
86511-0100

Practice Phone: 928-871-2822
Practice Fax: 928-871-2837

1588859789 — MISS ERICA LYNN KISH PT, MPT
Practice Location Address:

MUSTANG ROAD, 1 MILE NORTH OF RT 264
SAINT MICHAELS, AZ
86511-0100

Practice Phone: 928-871-2822
Practice Fax: 928-871-2837

Directions to “ DOLORES ARLT SULLIVAN SLP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.