Individual
JUSTIN LEE MODRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
2200 SW GAGE BLVD, TOPEKA, KS 66622-3340
(785) 350-3111
Mailing address
2000 SW GAGE BLVD, TOPEKA, KS 66604-3340
(785) 272-0778
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11365
KS
Other
Enumeration date
06/19/2019
Last updated
08/11/2021
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