Individual
ANNE MODENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1261 FURNACE BROOK PKWY STE 31, QUINCY, MA 02169-4787
(617) 479-4545
Mailing address
121 GROVE ST, # 110, WEST ROXBURY, MA 02132-4549
(617) 325-4917
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
201527
MA
Other
Enumeration date
04/18/2007
Last updated
07/17/2009
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