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Individual

DR. CHRIS H. MODRALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1248 NILLES RD, SUITE 8, FAIRFIELD, OH 45014-2762
(513) 269-4218
(513) 829-2830
Mailing address
PO BOX 18667, FAIRFIELD, OH 45018-0667
(513) 269-4218
(513) 829-2830

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4482
OH

Other

Enumeration date
10/01/2006
Last updated
07/08/2007
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