Individual
ASHLEY SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RADT-1
Contact information
Practice address
2844 COLOMA ST, PLACERVILLE, CA 95667-4406
(530) 333-9460
Mailing address
PO BOX 871, GARDEN VALLEY, CA 95633-0871
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/16/2021
Last updated
05/12/2021
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