Individual
MRS. STEPHANIE MODICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., CDE
Contact information
Practice address
7700 S BROADWAY, LITTLETON, CO 80122-2602
(720) 841-7907
(303) 683-6401
Mailing address
5850 CHEETAH CHASE, LITTLETON, CO 80124-9597
(720) 841-7907
(303) 683-6401
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
890669
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20320324
COMISSION ON DIETETIC REG
CO
01
—
890669
COMISSION ON DIETETIC REG
CO
Enumeration date
08/15/2006
Last updated
07/08/2007
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