Provider Demographics
NPI:1508958752
Name:WHITE, MOLLY M (PHD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:M
Last Name:WHITE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:711 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-5003
Mailing Address - Country:US
Mailing Address - Phone:901-448-6511
Mailing Address - Fax:901-448-7097
Practice Address - Street 1:9235 CROWN CREST BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8881
Practice Address - Country:US
Practice Address - Phone:303-841-4005
Practice Address - Fax:720-851-4890
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3115103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical