Individual
MRS. CARRIE MODRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1800 HOLLISTER DRIVE, SUITE 205, LIBERTYVILLE, IL 60048-1111
(847) 918-7947
(847) 918-9622
Mailing address
7811 GENEVA DR, GURNEE, IL 60031-9156
(847) 404-9264
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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