Provider Demographics
NPI:1437643400
Name:WALEGA, MOLLY ELIZABETH (RBT)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:ELIZABETH
Last Name:WALEGA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14770 ORCHARD PKWY UNIT 240
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9162
Mailing Address - Country:US
Mailing Address - Phone:719-331-0907
Mailing Address - Fax:
Practice Address - Street 1:11698 HURON ST STE 106
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-2920
Practice Address - Country:US
Practice Address - Phone:720-381-0264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician