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General NPI Number Information
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NPI Number | 1477362564
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Entity Type | Organization
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Legal Business Name | MOLLY SANDERS THERAPY, LLC
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 1331 OKEEFFE AVE APT 202
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City | SUN PRAIRIE
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State | WI
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Zip | 53590-4358
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Country | US
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Telephone | 608-620-3147
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Fax |
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Provider Business Mailing Address
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Address Line | 1331 OKEEFFE AVE APT 202
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City | SUN PRAIRIE
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State | WI
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Zip | 53590-4358
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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 | PRACTICE OWNER
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Name | MOLLY SANDERS
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Credential |
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Telephone | 608-620-3147
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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