Provider Demographics
NPI:1053651232
Name:CUPLER, MOLLY HARLACKER (MSOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:HARLACKER
Last Name:CUPLER
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:ANNE
Other - Last Name:HARLACKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOT, OTR/L
Mailing Address - Street 1:114 SKYLINE LN
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-8762
Mailing Address - Country:US
Mailing Address - Phone:724-283-3198
Mailing Address - Fax:
Practice Address - Street 1:114 SKYLINE LN
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-8762
Practice Address - Country:US
Practice Address - Phone:724-283-3198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-25
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017879174400000X
PAOC013904174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist