Dominique Sulla

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7152000240 Issued in MI

Practice address

1360 Porter St
Dearborn, MI 48124-2890

Phone

(313) 689-5188

NPI assigned

Oct 1, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Behavioral Outcomes Management,LLC

  • Community/Behavioral Health Agency
  • Troy, MI
  • NPI 1184139131

  Speech-Language Pathologist

  Medicare reassignment NPD
• Game Changer Pediatric Therapy Services LLC

  • Pediatric Occupational Therapist
  • Bay City, MI
  • NPI 1437506383
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1225513716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 PORTER ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242890",
            "telephone_number": "313-689-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 PORTER ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242890",
            "telephone_number": "313-689-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLA",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7152000240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asma Sufian
• Mamoon Sufyan
• Amirah Suggs
• Kevin M Suiter, MD
• Jiab Suleiman, DO
• Jaymie Elizabeth Sullins
• Laura Ann Sullivan, MD
• Tara Roberta Sullivan, RN,IBCLC,LCCE
• Zillay Huma Sultan, PA-C
• Onita Marshea Sumler

• Speech-Language Pathologist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.