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Individual

AUDRA NICOLE KOUROSMEHR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1450 N LAKE AVE STE 150, PASADENA, CA 91104-2388
(626) 794-1161
Mailing address
1450 N LAKE AVE STE 150, PASADENA, CA 91104-2388
(626) 794-1161

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CA

Other

Enumeration date
06/06/2023
Last updated
07/16/2024
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