Provider Demographics
NPI:1699011262
Name:SWENSON, MOLLY EM (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:EM
Last Name:SWENSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 HIGHWAY 12 E
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-5817
Mailing Address - Country:US
Mailing Address - Phone:320-235-5411
Mailing Address - Fax:
Practice Address - Street 1:1601 HIGHWAY 12 E
Practice Address - Street 2:SUITE 6
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-5817
Practice Address - Country:US
Practice Address - Phone:320-235-5411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-29
Last Update Date:2012-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1910106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist