Provider Demographics
NPI:1750631073
Name:MCDOWELL-BURNS, MOLLY JO (PC, IMFT)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:JO
Last Name:MCDOWELL-BURNS
Suffix:
Gender:F
Credentials:PC, IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 WADSWORTH RD
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-9503
Mailing Address - Country:US
Mailing Address - Phone:801-896-7509
Mailing Address - Fax:330-334-2235
Practice Address - Street 1:140 WADSWORTH RD
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-9503
Practice Address - Country:US
Practice Address - Phone:801-896-7509
Practice Address - Fax:330-334-2235
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1100605101YP2500X
OHM1200030106H00000X
OHF1600013106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional