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General NPI Number Information
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NPI Number | 1932983780
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Entity Type | Organization
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Legal Business Name | MOLLY RAE RESILIENCE COUNSELING LLC
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Dates
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Enumeration Date | 08/22/2023
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 2565 W ELLSWORTH RD
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City | ANN ARBOR
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State | MI
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Zip | 48108-9639
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Country | US
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Telephone | 414-412-3839
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Fax |
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Provider Business Mailing Address
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Address Line | 516 CHARLES ST
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City | YPSILANTI
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State | MI
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Zip | 48198-3811
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Country | US
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Telephone | 414-412-3839
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MOLLY ANDERSON
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Credential | LMSW
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Telephone | 810-835-1555
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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 |
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License Number State |
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