Provider Demographics
NPI:1679750343
Name:DERR, MOLLY WILLIAMS
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:WILLIAMS
Last Name:DERR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:WILLIAMS
Other - Last Name:DERR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01966-2220
Mailing Address - Country:US
Mailing Address - Phone:978-546-6727
Mailing Address - Fax:
Practice Address - Street 1:298 WASHINGTON ST
Practice Address - Street 2:HEALTH & EDUCATION SERVICES, INC
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-4832
Practice Address - Country:US
Practice Address - Phone:978-283-0296
Practice Address - Fax:978-283-2665
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)