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General NPI Number Information
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NPI Number | 1558158113
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Entity Type | Individual
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Provider Name | MOLLY RICHARDSON
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Gender | Female
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 1400 W 22ND ST
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1554
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Country | US
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Telephone | 605-322-5737
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Fax |
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Provider Business Mailing Address
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Address Line | 3378 RAE LN
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City | WOODBURY
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State | MN
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Zip | 55125-4904
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Country | US
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Telephone | 612-483-7775
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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