Provider Demographics
NPI:1871941310
Name:MOLLY MARR
Entity type:Organization
Organization Name:MOLLY MARR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-885-3878
Mailing Address - Street 1:13654 XAVIER LN STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-3607
Mailing Address - Country:US
Mailing Address - Phone:303-885-3878
Mailing Address - Fax:
Practice Address - Street 1:13654 XAVIER LN STE 100
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-3607
Practice Address - Country:US
Practice Address - Phone:303-885-3878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty