Healthcare Provider Details

I. General information

NPI: 1013943380
Provider Name (Legal Business Name): RONNI MICHELE MOLINARO MA CCCA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: RONNI MICHELE DROPKIN MD CCCA

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 PARK AVE SO
MINNEAPOLIS MN
55404-3753
US

IV. Provider business mailing address

2211 PARK AVE SO
MINNEAPOLIS MN
55404-3753
US

V. Phone/Fax

Practice location:
  • Phone: 612-871-1144
  • Fax: 612-871-2012
Mailing address:
  • Phone: 612-871-1144
  • Fax: 612-871-2012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number7459
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: