Individual
LISA MODLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC GEORGIA
Contact information
Practice address
114 E HALL ST, THOMSON, GA 30824-2726
(706) 295-2548
Mailing address
114 E HALL ST, THOMSON, GA 30824-2726
(706) 595-2548
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC010407
GA
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
About Stedi
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