Individual
AMBER NICHOLE MODGLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 FREEDOM CT, VACAVILLE, CA 95687-6777
(707) 631-5362
Mailing address
102 FREEDOM CT, VACAVILLE, CA 95687-6777
(707) 631-5362
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
Other
Enumeration date
07/29/2011
Last updated
07/29/2011
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