Provider Demographics
NPI:1376399725
Name:NOWELL, MOLLY
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:NOWELL
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 1:1920 14TH ST NW APT 315
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-3763
Mailing Address - Country:US
Mailing Address - Phone:732-759-1600
Mailing Address - Fax:
Practice Address - Street 1:2222 COLTS NECK RD
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-2843
Practice Address - Country:US
Practice Address - Phone:703-429-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist