Healthcare Provider Details

I. General information

NPI: 1124936893
Provider Name (Legal Business Name): MOLLY ROTHBLAT
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 W BROAD ST
QUAKERTOWN PA
18951-1215
US

IV. Provider business mailing address

524 W BROAD ST
QUAKERTOWN PA
18951-1216
US

V. Phone/Fax

Practice location:
  • Phone: 215-527-8012
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC020995
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: