Healthcare Provider Details

I. General information

NPI: 1689586414
Provider Name (Legal Business Name): MOLLY O'BRIEN M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 HILLCREST RD
WAYNE PA
19087-2423
US

IV. Provider business mailing address

421 KIRK LN
MEDIA PA
19063-2219
US

V. Phone/Fax

Practice location:
  • Phone: 610-405-8113
  • Fax:
Mailing address:
  • Phone: 484-574-7254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL019276
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: