Individual
BRANDON KAI SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RADT
Contact information
Practice address
527 S ARCHER ST, ANAHEIM, CA 92804-2421
(404) 748-3372
Mailing address
527 S ARCHER ST, ANAHEIM, CA 92804-2421
(404) 748-3372
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R141757121
CA
Other
Enumeration date
02/09/2021
Last updated
02/09/2021
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