Provider Demographics
NPI:1467761973
Name:MOLZON, NANCY (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:MOLZON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BOICE RD
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12538-1632
Mailing Address - Country:US
Mailing Address - Phone:845-229-4000
Mailing Address - Fax:
Practice Address - Street 1:648 NETHERWOOD RD
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:12538-2726
Practice Address - Country:US
Practice Address - Phone:845-229-4055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007908235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist