Individual
ANTHONY MICELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
121 DOWNEY AVE, MODESTO, CA 95354-1208
(209) 341-1824
Mailing address
121 DOWNEY AVE, MODESTO, CA 95354-1208
(209) 341-1824
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
53523
CA
Other
Enumeration date
04/12/2010
Last updated
12/20/2021
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