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1174307755
BREONNA KRISTINE SULLIVAN
LAKEWOOD, WA
NPI
1174307755
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-08-23
Last Update Date
2023-08-23
Business Address
BREONNA KRISTINE SULLIVAN
10015 LAKEWOOD DR SW
LAKEWOOD, WA 98499-3838
Phone number: 855-223-7123
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Mailing Address
BREONNA KRISTINE SULLIVAN
PO BOX 33568
SAN DIEGO, CA 92163-3568
Phone number: 855-223-7123
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