Healthcare Provider Details

I. General information

NPI: 1417876244
Provider Name (Legal Business Name): MOLLY HENKES OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 SHILOH RD E STE 205
ALPHARETTA GA
30005-8375
US

IV. Provider business mailing address

5955 SHILOH RD E STE 205
ALPHARETTA GA
30005-8375
US

V. Phone/Fax

Practice location:
  • Phone: 404-834-8404
  • Fax:
Mailing address:
  • Phone: 770-265-7625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT009919
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: