Provider Demographics
NPI:1578608980
Name:GERMASH, MOLLY (LM, CPM)
Entity Type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:
Last Name:GERMASH
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:FRAZIER
Other - Last Name:GERMASH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LM, CPM
Mailing Address - Street 1:PO BOX 80
Mailing Address - Street 2:
Mailing Address - City:PEASTER
Mailing Address - State:TX
Mailing Address - Zip Code:76485-0080
Mailing Address - Country:US
Mailing Address - Phone:972-896-8841
Mailing Address - Fax:
Practice Address - Street 1:226 LEE STREET
Practice Address - Street 2:
Practice Address - City:PEASTER
Practice Address - State:TX
Practice Address - Zip Code:76485
Practice Address - Country:US
Practice Address - Phone:972-896-8841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97020176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife