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1043990443
BRIAN SULLIVAN
INDIO, CA
NPI
1043990443
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-07-20
Last Update Date
2023-07-20
Business Address
BRIAN SULLIVAN
44374 PALM ST
INDIO, CA 92201-3117
Phone number: 760-342-6616
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Mailing Address
BRIAN SULLIVAN
44374 PALM ST
INDIO, CA 92201-3117
Phone number: 760-342-6616
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