Individual
MOSSIE HOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
THERAPIST
Contact information
Practice address
510 W 53RD ST, LOS ANGELES, CA 90037-3712
(323) 830-9960
Mailing address
510 W 53RD ST, LOS ANGELES, CA 90037-3712
(323) 830-9960
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
62867
CA
Other
Enumeration date
09/16/2014
Last updated
09/16/2014
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