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Individual

BRIAN KENNETH SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
250 MATHIS FERRY RD, SUITE 101, MT PLEASANT, SC 29464-2988
(843) 971-5171
(843) 971-5178
Mailing address
250 MATHIS FERRY RD, SUITE 101, MT PLEASANT, SC 29464-2988
(843) 971-5171
(843) 971-5178

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
622
SC

Other

Enumeration date
02/17/2008
Last updated
02/17/2008
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