Provider Demographics
NPI:1033366034
Name:MOTLEY, MICHAEL ARAM (BA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ARAM
Last Name:MOTLEY
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 W MERCED AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2533
Mailing Address - Country:US
Mailing Address - Phone:626-506-0727
Mailing Address - Fax:
Practice Address - Street 1:2109 W MERCED AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2533
Practice Address - Country:US
Practice Address - Phone:626-506-0727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health