| Doctor Name: | MACKENZIE MOLL |
| NPI Number: | 1033579081 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 16345 Ne 87th St #a-6 Redmond, WA - 980523503 |
| Business Phone Number: | 4256534960 |
| Business Fax Number: | 4256534961 |
| Mailing Address: | 1600 E Olive St, Sound Mental Health SEATTLE |
| State: | WA |
| Postal Code: | 981222735 |
| Phone Number: | 2063022200 |
| Fax Number: | 2063022210 |
| NPI Enumeration Date: | 03/03/2016 |
| NPI Last Update Date: | 03/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |