Individual
EDWARD A MODZELESKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CACII, CCS
Contact information
Practice address
2750 OLD ALABAMA RD, C/O THE SUMMIT COUNSELING, ALPHARETTA, GA 30022-8593
(678) 893-5300
Mailing address
501 HARBOR LNDG, ROSWELL, GA 30076-3113
(770) 313-3653
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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