Individual
MODENA JEAN MOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC SLP
Contact information
Practice address
11960 WESTLINE INDUSTRIAL DR, SUITE #201, SAINT LOUIS, MO 63146-3209
(314) 819-0480
Mailing address
11960 WESTLINE INDUSTRIAL DR, SUITE #201, SAINT LOUIS, MO 63146-3209
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1999138148
MO
Other
Enumeration date
09/04/2008
Last updated
09/04/2008
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