Provider Demographics
NPI:1780961128
Name:BAHR, MOLLY ANN (MA)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:ANN
Last Name:BAHR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 BISCAYNE BLVD UNIT 7
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3720
Mailing Address - Country:US
Mailing Address - Phone:305-204-2587
Mailing Address - Fax:
Practice Address - Street 1:3933 BISCAYNE BLVD UNIT 7
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3720
Practice Address - Country:US
Practice Address - Phone:305-204-2587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI374101YM0800X
FL17024101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health