Provider Demographics
NPI:1447514559
Name:MOLINA, MARRAH (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARRAH
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2643 APPIAN WAY
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2263
Mailing Address - Country:US
Mailing Address - Phone:510-854-8220
Mailing Address - Fax:
Practice Address - Street 1:2643 APPIAN WAY
Practice Address - Street 2:SUITE A-2
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2263
Practice Address - Country:US
Practice Address - Phone:510-854-8220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical