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General NPI Number Information
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NPI Number | 1306205422
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Entity Type | Organization
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Legal Business Name | JENNIFER TREADWAY-MOLLE, MA, LMFT, INC.
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Dates
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Enumeration Date | 02/17/2016
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Last Update Date | 02/17/2016
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Provider Practice Location Address
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Address Line | 101 S KRAEMER, SUITE 230
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City | PLACENTIA
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State | CA
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Zip | 92870-3501
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Country | US
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Telephone | 714-402-2719
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Fax | 714-993-3501
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Provider Business Mailing Address
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Address Line | 101 S KRAEMER, SUITE 230
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City | PLACENTIA
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State | CA
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Zip | 92870-3501
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Country | US
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Telephone | 714-402-2719
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Fax | 714-993-3501
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | JENNIFER TREADWAY-MOLLE
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Credential | LMFT
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Telephone | 714-402-2719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC49708
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License Number State | CA
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