Individual
KELLIE EASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6621 E PACIFIC COAST HWY, LONG BEACH, CA 90803-4200
(562) 270-6344
Mailing address
6621 E PACIFIC COAST HWY, LONG BEACH, CA 90803-4200
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/27/2017
Last updated
04/27/2017
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