Individual
KIMBERLY S MOLLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
600 GERMANTOWN PIKE STE A, LAFAYETTE HILL, PA 19444
(215) 290-0817
Mailing address
600 GERMANTOWN PIKE STE A, LAFAYETTE HILL, PA 19444-1800
(215) 290-0817
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
46TR00443400
NJ
174400000X
Specialist
Primary
OC010410
PA
174400000X
Specialist
U1-0001454
DE
225XM0800X
Mental Health Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022381
NEW YORK LICENSE
NY
01
—
46TR00443400
OCCUPATIONAL THERAPY LICENSURE
NJ
01
—
OC010410
OCCUPATIONAL THERAPY LICENSURE
PA
01
—
U1-0001454
DELAWARE LICENSURE
DE
Enumeration date
12/17/2007
Last updated
06/14/2019
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