Provider Demographics
NPI:1598971681
Name:MOLETT, MARIA T (MA)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:T
Last Name:MOLETT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 W CENTERVILLE RD
Mailing Address - Street 2:#211 D
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-5460
Mailing Address - Country:US
Mailing Address - Phone:972-898-2184
Mailing Address - Fax:972-692-8100
Practice Address - Street 1:629 W CENTERVILLE RD
Practice Address - Street 2:#211 D
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5460
Practice Address - Country:US
Practice Address - Phone:972-898-2184
Practice Address - Fax:972-692-8100
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94147101YM0800X
TX1678101YP2500X
TX424106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional