Individual
KEVIN PATRICK MOLLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
113 LINCOLN WAY EAST, MISHAWAKA, IN 46544-2016
(574) 255-4976
(574) 255-1882
Mailing address
113 LINCOLN WAY EAST, MISHAWAKA, IN 46544-2016
(574) 255-4976
(574) 255-1882
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002349A
IN
Other
Enumeration date
11/13/2006
Last updated
04/25/2012
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