Most Relevant Information
Provider Data
| NPI Number: | 1003028473 |
| Provider Name: | ROBERTA MARGARET ELLEDGE LMFT |
| Entity Type: | Individual |
| Taxonomy Code: | 106H00000X |
| Specialty: | Marriage & Family Therapist |
| License Number: | MFC31467 |
Most Important Dates
| Enumeration Date: | 05/05/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
819 15TH ST
MODESTO
CA
953541113
Practice Location Phone/Fax
| Phone: | 2095499608 |
| Fax: | 2095225700 |
Provider Mailing Location
819 15TH ST
MODESTO
CA
953541113
Provider Mailing Phone/Fax
| Phone: | 2095499608 |
| Fax: | 2095225700 |