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1104326198
SAMSON MOTAVASSEL
WEST HOLLYWOOD, CA
NPI
1104326198
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-02-15
Last Update Date
2018-10-10
Business Address
SAMSON MOTAVASSEL
8739 SANTA MONICA BLVD
WEST HOLLYWOOD, CA 90069-4507
Phone number: 310-623-1477
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Mailing Address
SAMSON MOTAVASSEL
8739 SANTA MONICA BLVD
LOS ANGELES, CA 90069-4507
Phone number: 310-623-1477
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