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Individual
MR. BEVIN JAY MODRAK
Active
Individual
MR. BEVIN JAY MODRAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC4698
ID
Other
Enumeration date
12/02/2011
Last updated
03/29/2023
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