Healthcare Provider Details

I. General information

NPI: 1750185740
Provider Name (Legal Business Name): CYNTHIA ROSE KIEHN-MOLA MA & PPS CREDENTAIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CINDI MOLA MA & PPS CREDENTIAL

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1897 S ST
ARCATA CA
95521-5474
US

IV. Provider business mailing address

PO BOX 522
BLUE LAKE CA
95525-0522
US

V. Phone/Fax

Practice location:
  • Phone: 707-825-8804
  • Fax: 707-825-1761
Mailing address:
  • Phone: 707-825-8804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: