Provider Demographics
NPI:1871482547
Name:VONDERHAAR, MOLLIE (LPMT, MT-BC)
Entity type:Individual
Prefix:
First Name:MOLLIE
Middle Name:
Last Name:VONDERHAAR
Suffix:
Gender:F
Credentials:LPMT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11223 CORNELL PARK DR STE 104
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-1835
Mailing Address - Country:US
Mailing Address - Phone:513-535-0810
Mailing Address - Fax:
Practice Address - Street 1:11223 CORNELL PARK DR STE 104
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-1835
Practice Address - Country:US
Practice Address - Phone:513-535-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHMUS.25000009225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist