Individual
JOHNNA CHATHAM MODLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
115-B REGENCY BLVD, GREENVILLE, NC 27834-4645
(252) 756-3099
(252) 756-0667
Mailing address
115-B REGENCY BLVD, GREENVILLE, NC 27834-4645
(252) 756-3099
(252) 756-0667
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6578
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7413022
—
NC
Enumeration date
08/19/2008
Last updated
09/27/2010
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