Blackmore, Molly S

Blackmore, Molly S is an individual health care provider with primary practice located at 8085 Wayzata Blvd Suite 101, Golden Valley MN 55426-1453. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Blackmore, Molly S can be contacted via phone (651) 769-6300.

Contact Information

Primary practice address
8085 Wayzata Blvd Suite 101 Golden Valley MN 55426-1453
Phone: (651) 769-6300
Fax: (651) 769-6349
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 1056 Minnesota

Profile Details

NPI number 1386621621
LBN Legal business name Blackmore, Molly S
Credentials LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2005
Last updated Oct 22nd, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386621621 NPPES
Minnesota MEDICAID 323684600

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