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General NPI Number Information
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NPI Number | 1467340919
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Entity Type | Individual
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Provider Name | JAQUELYN MOLINA ATP, COTA/L
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Gender | Female
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 12285 PELLICANO DR STE D5
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City | EL PASO
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State | TX
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Zip | 79936-6291
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Country | US
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Telephone | 915-341-7893
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Fax | 915-591-3136
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Provider Business Mailing Address
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Address Line | 12285 PELLICANO DR STE D5
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City | EL PASO
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State | TX
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Zip | 79936-6291
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Country | US
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Telephone | 915-341-7893
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number | 100588
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License Number State | TX
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