Healthcare Provider Details

I. General information

NPI: 1487585857
Provider Name (Legal Business Name): MOLLIE ALANA COCHRAN MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14567 MADISON RD
MIDDLEFIELD OH
44062-9499
US

IV. Provider business mailing address

3158 LODWICK DR NW APT 5
WARREN OH
44485-1554
US

V. Phone/Fax

Practice location:
  • Phone: 440-632-1668
  • Fax: 440-632-1697
Mailing address:
  • Phone: 724-337-4393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number70.001013TEMP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: