Provider Demographics
NPI:1326786930
Name:MOLINAR, SARITA CRISTAL
Entity Type:Individual
Prefix:
First Name:SARITA
Middle Name:CRISTAL
Last Name:MOLINAR
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 1:706 RAMBLE LN UNIT B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-3022
Mailing Address - Country:US
Mailing Address - Phone:512-718-8324
Mailing Address - Fax:
Practice Address - Street 1:1806 W STASSNEY LN STE 106
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3645
Practice Address - Country:US
Practice Address - Phone:512-718-8324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83567101YP2500X
TX18-368221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional