Individual
CHEYENNE TEY SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13901 AMARGOSA RD STE 2, VICTORVILLE, CA 92392-2409
(760) 962-9330
Mailing address
13901 AMARGOSA RD STE 2, VICTORVILLE, CA 92392-2409
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
E3871014
CA
Other
Enumeration date
01/20/2015
Last updated
01/20/2015
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