Provider Demographics
NPI:1780829416
Name:MCLAUGHLIN, MOLLY SARA (MA)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:SARA
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54495-2781
Mailing Address - Country:US
Mailing Address - Phone:715-570-4444
Mailing Address - Fax:
Practice Address - Street 1:320 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54495-2781
Practice Address - Country:US
Practice Address - Phone:715-570-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI43-228106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist