Individual
DAVID HOLTAN MOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LP
Contact information
Practice address
610 FLORENCE AVE, OWATONNA, MN 55060-4704
(507) 451-2630
(507) 455-8133
Mailing address
610 FLORENCE AVE, OWATONNA, MN 55060-4704
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 4859
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126989
UCARE
MN
01
—
15G19MO
BLUE CROSS BLUE SHIELD
MN
01
—
62-20365
UNITED BEHAVIORAL HEALTH
MN
05
—
793323100
—
MN
01
—
HP27427
HEALTH PARTNERS
MN
Enumeration date
10/12/2006
Last updated
02/15/2021
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