MEDICARE: KIMBERLY MOLNAR MFT LTD

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	106H00000X	Marriage & Family Therapist	0784	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861776429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIMBERLY MOLNAR MFT LTD

Provider Business Mailing Address
First Line	:	7495 W AZURE DR STE 218
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-4417
Country	:	US
Telephone Number	:	702-515-4015
Fax Number	:	702-202-6798

Provider Business Practice Location Address
First Line	:	7495 W AZURE DR STE 218
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-4417
Country	:	US
Telephone Number	:	702-515-4015
Fax Number	:	702-202-6798

Authorized Official
Title or Position	:	OWNER
Name	:	KIM MOLNAR
Credential	:	MFT LADC
Telephone Number	:	702-515-4015

Provider Enumeration Date	:	09/30/2011
Last Update Date	:	09/30/2011

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