Individual
LYNNE ANN MODZELESKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3404 BLACK TOWER CT, FAYETTEVILLE, NC 28306-8097
(610) 425-0752
(707) 253-5097
Mailing address
2100 NAPA VALLEJO HWY., NAPA, CA 94558-6293
(707) 253-5654
(707) 253-5097
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
29009
CA
103TC0700X
Clinical Psychologist
Primary
6144
NC
103TC0700X
Clinical Psychologist
PS017705
PA
Other
Enumeration date
11/25/2014
Last updated
04/22/2024
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