Provider Demographics
NPI:1801068267
Name:DOBSON, MOLLY M (MA, SLP)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:M
Last Name:DOBSON
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:S
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, SLP
Mailing Address - Street 1:2725 WATER RIDGE PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-4580
Mailing Address - Country:US
Mailing Address - Phone:704-831-5065
Mailing Address - Fax:704-831-5066
Practice Address - Street 1:11440 PARKSIDE DR
Practice Address - Street 2:SUITE 301
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2658
Practice Address - Country:US
Practice Address - Phone:865-777-3748
Practice Address - Fax:865-777-3827
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3690235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist