Provider Demographics
NPI:1144906256
Name:MARPLE, MOLLIE A
Entity type:Individual
Prefix:
First Name:MOLLIE
Middle Name:A
Last Name:MARPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4102 WOOLWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1851
Mailing Address - Country:US
Mailing Address - Phone:402-444-7415
Mailing Address - Fax:402-996-8171
Practice Address - Street 1:4102 WOOLWORTH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1851
Practice Address - Country:US
Practice Address - Phone:402-444-7415
Practice Address - Fax:402-996-8171
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE132731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical