Provider Demographics
NPI:1194333914
Name:MOLINARO, MYRNA EDITH (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MYRNA
Middle Name:EDITH
Last Name:MOLINARO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
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Mailing Address - Street 1:20212 CHAMPION FOREST DR
Mailing Address - Street 2:SUITE 700, UNIT 376
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-8783
Mailing Address - Country:US
Mailing Address - Phone:346-347-3775
Mailing Address - Fax:346-347-3875
Practice Address - Street 1:8900 EASTLOCH DRIVE
Practice Address - Street 2:BUILDING 135, SUITE O
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-2337
Practice Address - Country:US
Practice Address - Phone:346-347-3775
Practice Address - Fax:346-347-3875
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX115431235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist