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1437492352
GUSTAVO MORA
VAN NUYS, CA
NPI
1437492352
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-03-28
Last Update Date
2013-03-28
Business Address
-- GUSTAVO MORA
14540 HAMLIN ST STE I
VAN NUYS, CA 91411-4154
Phone number: 818-997-6876
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Mailing Address
-- GUSTAVO MORA
7225 BAKMAN AVE APT 2
SUN VALLEY, CA 91352-4906
Phone number: 818-503-1909
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