MR. Craig Alan Modell, PHD PSYCHOLOGIST

NPI #1366552887 in West Allis, Wisconsin

Provider Information

NPI Number: 1366552887
Entity Type: Individual
Name: MR. Craig Alan Modell, PHD PSYCHOLOGIST
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist
Credential: PHD PSYCHOLOGIST
Enumeration Date: Aug 30, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 10229 W GREENFIELD AVE
City: West Allis
State: Wisconsin
ZIP Code: 53214
Phone: (414) 453-6330

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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