Provider Demographics
NPI:1053137075
Name:SULLINGER, MILISSA MAE-RITCHEY (CPRS, CDCA)
Entity type:Individual
Prefix:
First Name:MILISSA
Middle Name:MAE-RITCHEY
Last Name:SULLINGER
Suffix:
Gender:F
Credentials:CPRS, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-1113
Mailing Address - Country:US
Mailing Address - Phone:216-501-2684
Mailing Address - Fax:
Practice Address - Street 1:1150 DAYTON ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-1113
Practice Address - Country:US
Practice Address - Phone:216-501-2684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.002853175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty