Provider Demographics
NPI:1225387244
Name:MOLLOY, SARAH B (ATR-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:B
Last Name:MOLLOY
Suffix:
Gender:F
Credentials:ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 CARRINGTON PL
Mailing Address - Street 2:APT 310
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-8689
Mailing Address - Country:US
Mailing Address - Phone:513-550-8200
Mailing Address - Fax:
Practice Address - Street 1:7577 CENTRAL PARKE BLVD
Practice Address - Street 2:SUITE 326
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6810
Practice Address - Country:US
Practice Address - Phone:513-770-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11-156101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor