Provider Demographics
NPI:1144637943
Name:BISHOP, MOLLY CARRIGG GREENE (MT-BC)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:CARRIGG GREENE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:56187-1060
Mailing Address - Country:US
Mailing Address - Phone:507-626-1685
Mailing Address - Fax:
Practice Address - Street 1:1635 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-1060
Practice Address - Country:US
Practice Address - Phone:507-626-1685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist