Provider Demographics
NPI:1740593144
Name:BABB, MOLLIE C (MCP, LPC)
Entity Type:Individual
Prefix:
First Name:MOLLIE
Middle Name:C
Last Name:BABB
Suffix:
Gender:F
Credentials:MCP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 W RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-3762
Mailing Address - Country:US
Mailing Address - Phone:580-278-5549
Mailing Address - Fax:
Practice Address - Street 1:3604 W RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-3762
Practice Address - Country:US
Practice Address - Phone:580-278-5549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health