| Modern Relationships Llc | |
|
245 S 16th St Philadelphia PA 19102-3332 | |
| (401) 575-0177 | |
| Not Available |
| Full Name | Modern Relationships Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 245 S 16th St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Kimberly Jackson (OWNER/ CLINICAL DIRECTOR) |
| Authorized Official Contact | 4015750177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Relationships Llc 1500 Chestnut St Suite 2 #1497 Philadelphia PA 19102-2700 Ph: () - | Modern Relationships Llc 245 S 16th St Philadelphia PA 19102-3332 Ph: (401) 575-0177 |
| NPI Number | 1215710652 |
|---|---|
| Provider Enumeration Date | 08/18/2023 |
| Last Update Date | 08/18/2023 |
| Certification Date | 08/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215710652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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