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NPI Code Detail

MEDICARE: MOLLY MEYER

MEDICARE: MOLLY MEYER
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
1103TS0200XSchool Psychologist1002261MN

General Provider Information

NPI Number : 1902739519
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY MEYER
Provider Business Mailing Address
First Line : 5621 COUNTY ROAD 101
Second Line :
City : MINNETONKA
State : MN
Zip : 55345-4214
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5621 COUNTY ROAD 101
Second Line :
City : MINNETONKA
State : MN
Zip : 55345-4214
Country : US
Telephone Number : 952-401-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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Directions to “ MOLLY MEYER ” Practice Location

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