Provider Demographics
NPI:1851808711
Name:PUTYRAE, MOLLIE OLINE (LMHC MHP)
Entity Type:Individual
Prefix:
First Name:MOLLIE
Middle Name:OLINE
Last Name:PUTYRAE
Suffix:
Gender:F
Credentials:LMHC MHP
Other - Prefix:
Other - First Name:MOLLIE
Other - Middle Name:OLINE
Other - Last Name:SCHWEIGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2411 E 34TH CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4676
Mailing Address - Country:US
Mailing Address - Phone:509-981-3104
Mailing Address - Fax:
Practice Address - Street 1:1404 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-3502
Practice Address - Country:US
Practice Address - Phone:509-744-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-01
Last Update Date:2018-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60695074101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health