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General NPI Number Information
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NPI Number | 1245199421
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Entity Type | Individual
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Provider Name | MOLLY MARIE IRISH
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Gender | Female
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Dates
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Enumeration Date | 01/21/2026
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 6752 OLD MCLEAN VILLAGE DR STE LL
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City | MC LEAN
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State | VA
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Zip | 22101-3984
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Country | US
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Telephone | 703-297-5681
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Fax |
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Provider Business Mailing Address
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Address Line | 2818 SHAWN LEIGH DR
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City | VIENNA
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State | VA
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Zip | 22181-6138
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0704017718
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License Number State | VA
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