Individual
CASEY MOUTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8831 VENICE BLVD, LOS ANGELES, CA 90034-3223
(818) 416-3835
Mailing address
4440 IRVINE AVE, STUDIO CITY, CA 91602-1914
(818) 416-3835
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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