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1376037267
KATHLEEN MODDERNO
LEXINGTON, MA
NPI
1376037267
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MA 114205)
Enumeration Date
2018-06-14
Last Update Date
2018-06-14
Business Address
KATHLEEN MODDERNO LICSW
187 SPRING ST
LEXINGTON, MA 02421-8030
Phone number: 781-861-7081
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Mailing Address
KATHLEEN MODDERNO LICSW
164 NEWTON ST APT 1
BRIGHTON, MA 02135-1545
Phone number:
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