Organization
JODI MOLLICA LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI MOLLICA LCSW (LICENSED CLINICAL SOCIAL WORKER)
(248) 321-8684
Entity
Organization
Contact information
Practice address
628 E PARENT AVE STE 506, ROYAL OAK, MI 48067-3768
(248) 321-8684
Mailing address
1040 MOHAWK AVE, ROYAL OAK, MI 48067-3330
(248) 321-8684
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801091687
LICENSE
MI
Enumeration date
11/05/2019
Last updated
11/05/2019
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