Provider Demographics
NPI:1871226357
Name:MOLINA, OLGA (DSW, LCSW)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1559 MAIDENCANE LOOP
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7463
Mailing Address - Country:US
Mailing Address - Phone:561-251-2719
Mailing Address - Fax:
Practice Address - Street 1:1559 MAIDENCANE LOOP
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-7463
Practice Address - Country:US
Practice Address - Phone:561-251-2719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-02
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW64571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical