Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003136185 |
---|---|
Provider Name | Marylu Molina |
First Address | Los Angeles, CA 90036-5252 |
Second Address | Los Angeles, CA 90036-5252 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2010 |
Last Update Date | 01/09/2011 |