Provider Demographics
NPI:1467663377
Name:MOLTON, WARREN LANE (RELIGIOUS DOCTOR REL)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:LANE
Last Name:MOLTON
Suffix:
Gender:M
Credentials:RELIGIOUS DOCTOR REL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22335
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-0335
Mailing Address - Country:US
Mailing Address - Phone:816-361-2594
Mailing Address - Fax:
Practice Address - Street 1:607 W 66TH TERRACE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64113-0335
Practice Address - Country:US
Practice Address - Phone:816-361-2594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral