Healthcare Provider Details

I. General information

NPI: 1225861305
Provider Name (Legal Business Name): MOLLY MARIE TRANSOU CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 VISTA RD
FORT MILL SC
29708-7800
US

IV. Provider business mailing address

411 BILLINGSLEY RD STE 103
CHARLOTTE NC
28211-1066
US

V. Phone/Fax

Practice location:
  • Phone: 839-400-2400
  • Fax:
Mailing address:
  • Phone: 704-280-8891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number8967
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: