Provider Demographics
NPI:1114600046
Name:ORETADE, MOLABO (QMHP-R)
Entity Type:Individual
Prefix:MRS
First Name:MOLABO
Middle Name:
Last Name:ORETADE
Suffix:
Gender:F
Credentials:QMHP-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 N POTOMAC ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-4805
Mailing Address - Country:US
Mailing Address - Phone:240-420-1850
Mailing Address - Fax:
Practice Address - Street 1:714 MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-6010
Practice Address - Country:US
Practice Address - Phone:541-880-4921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling