Individual
MRS. LAURA EMILY MODICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
260 CLARKSON RD, ELLISVILLE, MO 63011-2245
(573) 747-6445
Mailing address
260 CLARKSON RD, ELLISVILLE, MO 63011-2245
(573) 747-6445
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2012018427
MO
Other
Enumeration date
08/28/2015
Last updated
03/16/2026
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