Provider Demographics
NPI:1770225286
Name:MOLETRESS, JOHN (MFA MA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MOLETRESS
Suffix:
Gender:M
Credentials:MFA MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130-134 ARCH STREET
Mailing Address - Street 2:#101
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106
Mailing Address - Country:US
Mailing Address - Phone:202-236-9953
Mailing Address - Fax:
Practice Address - Street 1:130-134 ARCH STREET
Practice Address - Street 2:#101
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106
Practice Address - Country:US
Practice Address - Phone:202-236-9953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional