Individual
ELIZABETH MODICLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
160 OSBORN ST, FALL RIVER, MA 02724-2814
(508) 676-5708
Mailing address
51 HAWTHORNE ST, NORTH PROVIDENCE, RI 02904-3816
(814) 386-4565
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/20/2016
Last updated
02/04/2026
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