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General NPI Number Information
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NPI Number | 1912353855
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Entity Type | Individual
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Provider Name | RENEE R MOLZON MSSA, LISW
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Gender | Female
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Dates
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Enumeration Date | 05/10/2016
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 447 SOUTH ST
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City | CHARDON
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State | OH
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Zip | 44024-1505
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Country | US
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Telephone | 440-462-0123
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 495
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City | CHARDON
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State | OH
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Zip | 44024-0495
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Country | US
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Telephone | 440-462-0123
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Fax | 440-223-9145
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I1700370
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License Number State | OH
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