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1770056608
SCOTT LAMAR SULLIVAN
EUREKA, CA
NPI
1770056608
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R8764)
Enumeration Date
2019-01-03
Last Update Date
2024-09-19
Business Address
SCOTT LAMAR SULLIVAN
404 H ST
EUREKA, CA 95501-1022
Phone number: 707-599-9875
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Mailing Address
SCOTT LAMAR SULLIVAN
720 WOOD ST
EUREKA, CA 95501-4413
Phone number: 707-268-2990
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