Individual
MISS COLETTE MOLLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2500 COMO AVE, MAIL STOP 31100A, SAINT PAUL, MN 55108-1460
(651) 641-6200
(651) 641-6205
Mailing address
8170 33RD AVE S, MINNEAPOLIS, MN 55425-4516
(651) 641-6200
(651) 641-6205
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
23196
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149010099
LCSW
IL
Enumeration date
05/23/2007
Last updated
10/18/2018
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