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Individual

SEVIL H MODESTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2040 MILLBURN AVE STE 102, MAPLEWOOD, NJ 07040-3716
(732) 762-2406
Mailing address
2040 MILLBURN AVE STE 102, MAPLEWOOD, NJ 07040-3716

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00317600
NJ
104100000X
Social Worker
Primary
44SL06432300
NJ

Other

Enumeration date
06/11/2020
Last updated
09/09/2022
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