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General NPI Number Information
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NPI Number | 1194333914
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Entity Type | Individual
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Provider Name | MYRNA EDITH MOLINARO M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 8900 EASTLOCH DRIVE BUILDING 135, SUITE O
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City | SPRING
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State | TX
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Zip | 77379-2337
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Country | US
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Telephone | 346-347-3775
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Fax | 346-347-3875
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Provider Business Mailing Address
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Address Line | 20212 CHAMPION FOREST DR SUITE 700, UNIT 376
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City | SPRING
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State | TX
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Zip | 77379-8783
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Country | US
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Telephone | 346-347-3775
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Fax | 346-347-3875
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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 | 115431
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License Number State | TX
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