Provider Demographics
NPI:1902196207
Name:WEINBERGER, MOLLY JEAN
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:JEAN
Last Name:WEINBERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3520
Mailing Address - Country:US
Mailing Address - Phone:507-931-8040
Mailing Address - Fax:
Practice Address - Street 1:226 N BROAD ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3520
Practice Address - Country:US
Practice Address - Phone:507-931-8040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health