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General NPI Number Information
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NPI Number | 1669934303
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Entity Type | Individual
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Provider Name | ALICE WARE MOLLISON MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 04/02/2019
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Provider Practice Location Address
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Address Line | 901 CASTRO ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-3209
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Country | US
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Telephone | 415-550-8255
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Fax |
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Provider Business Mailing Address
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Address Line | 1367 DE HARO ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-3238
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Country | US
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Telephone | 413-687-9085
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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 | 24514
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License Number State | CA
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