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1255957973
MARIO MORA
LOS ANGELES, CA
NPI
1255957973
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 10482)
Enumeration Date
2020-06-18
Last Update Date
2020-06-18
Business Address
Mr. MARIO MORA SUDRC
5723 WHITTIER BLVD
LOS ANGELES, CA 90022-4222
Phone number: 323-721-6855
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Mailing Address
Mr. MARIO MORA SUDRC
7320 EXETER ST APT 5
PARAMOUNT, CA 90723-3333
Phone number: 562-469-2757
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