Provider Demographics
NPI:1578905287
Name:SOWLES, MOLLY WOODRUFF
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:WOODRUFF
Last Name:SOWLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 BROAD ARROW TRL
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6327
Mailing Address - Country:US
Mailing Address - Phone:207-939-7772
Mailing Address - Fax:
Practice Address - Street 1:40 BROAD ARROW TRL
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6327
Practice Address - Country:US
Practice Address - Phone:207-939-7772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker