Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | E 0007858 | OH |
N | 104100000X | Social Worker | S 0022957 | OH |
NPI | 1003022567 |
---|---|
Provider Name | Molly Marie Fields |
First Address | Columbus, OH 43220-2690 |
Second Address | Columbus, OH 43220-2690 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 08/07/2007 |