Healthcare Provider Details

I. General information

NPI: 1447349147
Provider Name (Legal Business Name): ROSE MARY MOLITOR MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 3RD ST N
SAINT CLOUD MN
56303-4033
US

IV. Provider business mailing address

923 PARKVIEW LN
SARTELL MN
56377-2227
US

V. Phone/Fax

Practice location:
  • Phone: 320-253-5930
  • Fax: 320-258-4632
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLP3492
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: