Individual
AMY MODLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, CAADC
Contact information
Practice address
401 WEST FULTON ST, GRAND RAPIDS, MI 49504
(616) 610-0591
Mailing address
401 WEST FULTON ST, GRAND RAPIDS, MI 49504
(616) 610-0591
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
106691
CA
1041C0700X
Clinical Social Worker
2028
NH
1041C0700X
Clinical Social Worker
6801090715
MI
Other
Enumeration date
07/21/2009
Last updated
01/26/2023
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