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NPI Code Detail

MEDICARE: JONATHAN ANTONIO MOLINA LMFT-I

MEDICARE: JONATHAN ANTONIO MOLINA LMFT-I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistNV

General Provider Information

NPI Number : 1689335119
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN ANTONIO MOLINA LMFT-I
Provider Business Mailing Address
First Line : 4739 EVERMAN DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89122-6610
Country : US
Telephone Number : 702-272-4572
Fax Number :
Provider Business Practice Location Address
First Line : 4739 EVERMAN DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89122-6610
Country : US
Telephone Number : 702-272-4572
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2022
Last Update Date : 01/06/2022

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Directions to “ JONATHAN ANTONIO MOLINA LMFT-I” Practice Location

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