Provider Demographics
NPI:1336579143
Name:MONAHAN HOWE, MOLLY (DACM, LAC)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:
Last Name:MONAHAN HOWE
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12885 E BUMPY RD
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-9777
Mailing Address - Country:US
Mailing Address - Phone:928-600-5102
Mailing Address - Fax:
Practice Address - Street 1:1585 S PLAZA WAY STE 150
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-7156
Practice Address - Country:US
Practice Address - Phone:928-226-1556
Practice Address - Fax:855-821-1779
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1323171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist