Provider Demographics
NPI:1629454558
Name:HAMBY, MOLLY KAITLIN (BSW, QMHA)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:KAITLIN
Last Name:HAMBY
Suffix:
Gender:F
Credentials:BSW, QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 CRESTWAY RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7726
Mailing Address - Country:US
Mailing Address - Phone:702-303-5111
Mailing Address - Fax:
Practice Address - Street 1:6600 W CHARLESTON BLVD
Practice Address - Street 2:#140
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-9001
Practice Address - Country:US
Practice Address - Phone:702-437-4673
Practice Address - Fax:702-438-4673
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst