Individual
IRMA MODESTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2152 N FRONT ST, PHILADELPHIA, PA 19122-1705
(484) 221-9136
(484) 221-9130
Mailing address
2030 W TILGHMAN ST, SUITE 105B, ALLENTOWN, PA 18104-4354
(484) 221-9136
(484) 221-9130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/13/2007
Last updated
11/13/2007
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