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1215324207
CLEMENT SULLIVAN
SAN ANTONIO, TX
NPI
1215324207
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-04-17
Last Update Date
2015-04-17
Business Address
-- CLEMENT SULLIVAN
519 E QUINCY ST
SAN ANTONIO, TX 78215-1605
Phone number: 210-299-1614
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Mailing Address
-- CLEMENT SULLIVAN
519 E QUINCY ST
SAN ANTONIO, TX 78215-1605
Phone number: 210-299-1614
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