Provider Information for 1982789053
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MOLLY RAFFERTY LPC
Sex: Female
NPI: 1982789053
Last Updated: 2007-07-09
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1982789053 | ||||||||||||
| Enumeration Date | 2006-10-26 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 5807 FOXCROFT DR AMARILLO, TX 79109-7433 United States Phone: 806-468-8900 | Fax:806-468-8902 | ||||||||||||
| Primary Practice Address | 912 CLYDE ST AMARILLO, TX 79106-4206 United States Phone: 806-468-8900 | Fax:806-468-8902 | ||||||||||||
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