Provider Demographics
NPI:1336452283
Name:KEHR, MOLLY
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:KEHR
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 1:14300 NICOLLET CT
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-4501
Mailing Address - Country:US
Mailing Address - Phone:952-435-8814
Mailing Address - Fax:952-435-7705
Practice Address - Street 1:14300 NICOLLET CT
Practice Address - Street 2:SUITE 130
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-4501
Practice Address - Country:US
Practice Address - Phone:952-435-8814
Practice Address - Fax:952-435-7705
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1964106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist