Individual
MISS MOLLY J TICKNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, ATR, LPC
Contact information
Practice address
18600 E 37TH TER S, INDEPENDENCE, MO 64057-1707
(816) 659-9383
Mailing address
18600 E 37TH TER S, INDEPENDENCE, MO 64057-1707
(816) 659-9383
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2004014995
MO
101YP2500X
Professional Counselor
Primary
2004014955
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
499302701
—
MO
Enumeration date
09/20/2006
Last updated
07/26/2022
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