Healthcare Provider Details

I. General information

NPI: 1124624747
Provider Name (Legal Business Name): HAZEL MOLDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2020
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1571 SHARONWOOD DR
COSHOCTON OH
43812-3002
US

IV. Provider business mailing address

1571 SHARONWOOD DR
COSHOCTON OH
43812-3002
US

V. Phone/Fax

Practice location:
  • Phone: 330-600-4394
  • Fax:
Mailing address:
  • Phone: 330-600-4394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: