Provider Demographics
NPI:1205506649
Name:JONART, MOLLIE BROWNE (MA)
Entity type:Individual
Prefix:MS
First Name:MOLLIE
Middle Name:BROWNE
Last Name:JONART
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:MOLLIE
Other - Middle Name:BROWNE
Other - Last Name:SPROUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5861 CEDAR LAKE RD S
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1653
Mailing Address - Country:US
Mailing Address - Phone:715-340-6244
Mailing Address - Fax:
Practice Address - Street 1:5861 CEDAR LAKE RD S
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1653
Practice Address - Country:US
Practice Address - Phone:612-202-8703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health