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General NPI Number Information
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NPI Number | 1649771858
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Entity Type | Individual
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Provider Name | MICHAEL MOLINO SLP
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Gender | Male
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Dates
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Enumeration Date | 02/22/2018
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Last Update Date | 02/22/2018
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Provider Practice Location Address
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Address Line | 2530 DOUGLAS BLVD
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City | ROSEVILLE
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State | CA
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Zip | 95661-3989
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Country | US
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Telephone | 916-797-3307
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Fax |
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Provider Business Mailing Address
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Address Line | 5599 LATIN WAY
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City | FAIR OAKS
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State | CA
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Zip | 95628-2926
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Country | US
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Telephone | 951-973-9369
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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