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Individual
ELIZABETH MODDE
Active
Individual
ELIZABETH MODDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
1027658
MA
2084P0800X
Psychiatry Physician
1027658
MA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
1027658
MA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
LP05314
RI
Other
Enumeration date
05/14/2021
Last updated
06/29/2026
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