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NPI 1003513003

NPI 1003513003 : ALEXANDRA MOLL : CAROLINA, PR

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General NPI Number Information
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    NPI Number           |    1003513003
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    Entity Type          |    Individual 
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    Provider Name        |    ALEXANDRA MOLL
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/09/2023
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    Last Update Date     |    02/09/2023
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Provider Practice Location Address
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    Address Line         |    CAMPO RICO OFFICE PLAZA ST 103 AVE ROBERTO SANCHEZ VILELLA
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    City                 |    CAROLINA
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    State                |    PR
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    Zip                  |    00983
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    Country              |    US
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    Telephone            |    787-247-9466
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1589 CALLE ATUN 
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    City                 |    CAROLINA
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    State                |    PR
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    Zip                  |    00983-1456
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    Country              |    US
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    Telephone            |    787-247-9466
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    4461
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    License Number State |    PR
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