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General NPI Number Information
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NPI Number | 1184501454
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Entity Type | Organization
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Legal Business Name | MOLLIE BAKER THERAPY LLC
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 327 WILBUR CEMETERY RD
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City | WILBUR
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State | OR
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Zip | 97494-0201
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Country | US
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Telephone | 267-619-4973
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Fax | 800-433-1396
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Provider Business Mailing Address
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Address Line | PO BOX 1787
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City | MEDFORD
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State | OR
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Zip | 97501-0261
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Country | US
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Telephone | 541-500-8655
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Fax | 800-433-1396
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Authorized Official
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Title or Position | OWNER
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Name | MOLLIE BAKER
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Credential | LCSW
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Telephone | 267-619-4973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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