MEDICARE: THERESE B MOLLOY OT/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	00745	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00745	OTHER	IA	IOWA OT LICENSE

General Provider Information

NPI Number	:	1003854027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESE B MOLLOY OT/L

Provider Business Mailing Address
First Line	:	6915 WILTON CT NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-1448
Country	:	US
Telephone Number	:	319-270-8492
Fax Number	:	319-373-3197

Provider Business Practice Location Address
First Line	:	44 STURGIS CORNER DR
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52246-5617
Country	:	US
Telephone Number	:	319-270-8492
Fax Number	:	319-373-3197

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	12/24/2025

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