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Individual

CAROL MODDELMOG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCMFT

Contact information

Practice address
1700 E IRON AVE, SALINA, KS 67401-3401
(785) 577-9802
Mailing address
1700 E IRON AVE, SALINA, KS 67401-3401
(785) 577-9802

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
194
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200430380A
KS
Enumeration date
06/06/2006
Last updated
02/27/2026
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