Individual
MOLLIBETH PENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 N EAGLESON AVE, BLOOMINGTON, IN 47405-3190
(812) 855-5711
Mailing address
2003 W ROSS LN, BLOOMINGTON, IN 47403-2041
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39005525A
IN
Other
Enumeration date
07/17/2025
Last updated
07/17/2025
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