Individual
MIRIAM LIZETH FLORES PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 W BRIGGSMORE AVE, MODESTO, CA 95350-3839
(209) 526-1476
Mailing address
2314 CHATKA LN, SAN BERNARDINO, CA 92410-2000
(909) 264-5486
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
08/05/2021
Last updated
05/15/2025
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