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1073026894
MELISSA M MOUTON-JACKSON
LOS ANGELES, CA
NPI
1073026894
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-11-15
Last Update Date
2017-11-15
Business Address
Mrs. MELISSA M MOUTON-JACKSON
2118 S CENTRAL AVE
LOS ANGELES, CA 90011-1237
Phone number: 213-493-4664
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Mailing Address
Mrs. MELISSA M MOUTON-JACKSON
2118 S CENTRAL AVE
LOS ANGELES, CA 90011-1237
Phone number: 213-493-4664
Copy
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