Provider Demographics
NPI:1417032129
Name:MOLLOY, GAIL F (PT, COMT, OCS)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:F
Last Name:MOLLOY
Suffix:
Gender:F
Credentials:PT, COMT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27623 FAWN DR
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-7216
Mailing Address - Country:US
Mailing Address - Phone:303-757-1554
Mailing Address - Fax:
Practice Address - Street 1:3601 S PEARL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3805
Practice Address - Country:US
Practice Address - Phone:303-757-1554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2357174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC5523Medicare ID - Type Unspecified