Basic Information
Provider Information
NPI: 1831709054
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HEPNER
FirstName: MOLLY
MiddleName: CATHERINE
NamePrefix:  
NameSuffix:  
Credential: MS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 1ST ST NE FL 9
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200027953
CountryCode: US
TelephoneNumber: 2024425885
FaxNumber:  
Practice Location
Address1: 1200 1ST ST NE FL 9
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200027953
CountryCode: US
TelephoneNumber: 2024425885
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/03/2020
LastUpdateDate: 08/31/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/31/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000XSLPCF000080DCY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


Home