Doctor Name: | DR. MOLLY B CONNELLY |
NPI Number: | 1235285552 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. |
License Number: | 194 |
Business Practice Address: | 2644 Lake Shore Rd Gilford, NH - 032497672 |
Business Phone Number: | 6032934990 |
Business Fax Number: | |
Mailing Address: | 2644 Lake Shore Rd, GILFORD |
State: | NH |
Postal Code: | 032497672 |
Phone Number: | 6032934990 |
Fax Number: | |
NPI Enumeration Date: | 01/27/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 194 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |