| Molly Larson, Ph.d. | |
|
122 4th Ave Suite 200 Indialantic FL 32903-3112 | |
| (321) 327-3793 | |
| Not Available |
| Full Name | Molly Larson, Ph.d. |
|---|---|
| Speciality | Psychologist |
| Location | 122 4th Ave, Indialantic, Florida |
| Authorized Official Name and Position | Molly Larson (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 3213273793 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Molly Larson, Ph.d. 122 4th Ave Suite 200 Indialantic FL 32903-3112 Ph: (321) 327-3793 | Molly Larson, Ph.d. 122 4th Ave Suite 200 Indialantic FL 32903-3112 Ph: (321) 327-3793 |
| NPI Number | 1447609649 |
|---|---|
| Provider Enumeration Date | 06/08/2016 |
| Last Update Date | 06/08/2016 |
| Medicare PECOS PAC ID | 7315234564 |
|---|---|
| Medicare Enrollment ID | O20161003001046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447609649 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY9437 (Florida) | Primary |
| Provider Name | Molly K Larson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548652795 PECOS PAC ID: 3779870936 Enrollment ID: I20200611000835 |
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