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Individual
ELISABETH KAREN MODESTINO
Active
Individual
ELISABETH KAREN MODESTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
117393
MA
1041C0700X
Clinical Social Worker
Primary
ISW02948
RI
Other
Enumeration date
04/27/2010
Last updated
05/17/2019
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