Healthcare Provider Details

I. General information

NPI: 1306251285
Provider Name (Legal Business Name): MOLLIE HOBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 02/23/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2124 SPENCER CT
LAGRANGE KY
40031
US

IV. Provider business mailing address

1900 BASHFORD MANOR LN UNIT K104
LOUISVILLE KY
40218-2491
US

V. Phone/Fax

Practice location:
  • Phone: 502-222-7201
  • Fax:
Mailing address:
  • Phone: 270-860-1823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number290383
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: