Provider Demographics
NPI:1689443087
Name:MCGLYNN, MOLLY JANE I
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:JANE
Last Name:MCGLYNN
Suffix:I
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 1:10600 4TH ST N APT 605
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-3203
Mailing Address - Country:US
Mailing Address - Phone:172-738-5492
Mailing Address - Fax:
Practice Address - Street 1:10600 4TH ST N APT 605
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-3203
Practice Address - Country:US
Practice Address - Phone:727-385-4920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant