Individual
BRANDI SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4440 FORT SHAW DR, NEW PORT RICHEY, FL 34655-7314
(813) 751-4804
Mailing address
4440 FORT SHAW DR, NEW PORT RICHEY, FL 34655-7314
(813) 751-4804
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW19390
FL
Other
Enumeration date
02/24/2022
Last updated
09/03/2024
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