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Individual

BRIDGET MODICA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8681 WESLEYAN DR, APT. 6-19, FORT MYERS, FL 33919-5260
(239) 728-7976
(239) 236-3597
Mailing address
8681 WESLEYAN DR, APT. 6-19, FORT MYERS, FL 33919-5260
(239) 728-7976
(239) 236-3597

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
03/12/2007
Last updated
07/08/2007
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