Provider Demographics
NPI:1902097728
Name:KEITH, MOLLY BETH (PSYD)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:BETH
Last Name:KEITH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4871 TATERSALL CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-8300
Mailing Address - Country:US
Mailing Address - Phone:925-209-1409
Mailing Address - Fax:
Practice Address - Street 1:4871 TATERSALL CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-8300
Practice Address - Country:US
Practice Address - Phone:925-209-1409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation