| Modern Therapy | |
|
1210 Fountain Cove Ln Lawrenceville GA 30043-3974 | |
| (513) 449-0445 | |
| (513) 672-9859 |
| Full Name | Modern Therapy |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1210 Fountain Cove Ln, Lawrenceville, Georgia |
| Authorized Official Name and Position | Robyn J Kelly (OWNER) |
| Authorized Official Contact | 5134490445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Therapy 1210 Fountain Cove Ln Lawrenceville GA 30043-3974 Ph: (513) 449-0445 | Modern Therapy 1210 Fountain Cove Ln Lawrenceville GA 30043-3974 Ph: (513) 449-0445 |
| NPI Number | 1043917909 |
|---|---|
| Provider Enumeration Date | 02/10/2023 |
| Last Update Date | 02/10/2023 |
| Certification Date | 02/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043917909 | NPI | - | NPPES |
| 1225280142 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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