Basic Information
| Provider Information | |||||||||
| NPI: | 1295860963 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCLAUGHLIN | ||||||||
| FirstName: | MOLLY | ||||||||
| MiddleName: | ALENE | ||||||||
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| Credential: | OTR/L, MA COUNSELING | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1650 UNIVERSITY BLVD NE | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871021726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052728950 | ||||||||
| FaxNumber: | 5052723202 | ||||||||
| Practice Location | |||||||||
| Address1: | 2300 MENAUL BLVD NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871071851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052728950 | ||||||||
| FaxNumber: | 5052723202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2007 | ||||||||
| LastUpdateDate: | 08/14/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 0103921 | NM | Y | Behavioral Health & Social Service Providers | Counselor | 225X00000X | 401 | NM | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.