Individual
SOUZAN MOSLEHSHIRAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 MAIN STREET SUITE 300, COLOMBIA, SC 29201
(877) 418-2978
(866) 500-2186
Mailing address
3214 SPECTRUM, IRVINE, CA 92618
(949) 526-5662
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
CA
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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