Individual
COLIN DAVID SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4150 UTE DR, SAN DIEGO, CA 92117-5853
(858) 283-8941
Mailing address
4150 UTE DR, SAN DIEGO, CA 92117-5853
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
02/02/2018
Last updated
04/14/2023
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